THE RELATION OF CLINICAL BRAIN SINGS AND STRUCTURAL CHANGES OF A BRAIN IN ESSENTIAL HYPERTENSIVE PATIENTS: PP.4.130

Abstract

Objective: To study relation between severity of clinical brain symptoms and structural brain changes in hypertensive patients. Methods: A hundred and fifty two essential hypertensive patients, 79 men and 73 women, aged between 30–60 years, were included in the study. General clinical investigation and brain MRI were performed in all patients. Presence of leucoaraiosis (PL), lacuna infarcts (LI) and focal white matter lesions (FWML) were evaluated in all patients. Severity of structural brain changes was rated in grades: minimal grade 0–1, moderate grade 2–4, and severe - as grade 5–7. We compared groups of patients without clinical symptoms (I group, n = 39), with mild (rare 1–2 times a week headaches) (II group, n = 59) and severe (frequent headache, dizziness, photopsies with minor local deficit) symptoms (III group, n = 54). Results: Structural brain changes were detected in 69.8%, 71.2% and 100% patients accordingly. The patients of III group more frequently had PL of 2–3 degrees, than the patients of II (x2 = 7,26, ð = 0,007) and I group (x2 = 10,87, ð = 0,002) and LI (x2 = 6,47, ð = 0,01 è x2 = 5,73, ð = 0,016 accordingly). Also mutiple FWML and LI were more frequent in III than in II groups (x2 = 4,02, ð = 0,045 and x2 = 4,97, ð = 0,026 accordingly). The minimal structural changes were observed significantly more often in I group than in II (x2 = 4.1, ð = 0,04) and III groups (x2 = 7,41, ð = 0,006). Severe structural changes were observed significantly more frequent in III group than in II (x2 = 7.91, ð = 0,004) and I groups (x2 = 7,52, ð = 0,006). In patients of I and II groups with structural brain changes 24-h systolic blood pressure load was significantly higher than in patients without them. Conclusion: Our study demonstrates that at the majority of patients severity of clinical brain symptoms corresponds to severity of structural brain changes. However, frequently structural brain changes precede development of clinical brain symptoms and brain MRI may help to detect latent structural brain changes in hypertensive patients. Systolic blood pressure load may predict development of latent structural brain changes.