TYPES OF INITIAL ORTHOSTATIC REACTIONS DURING ACTIVE ORTHOSTATIC TEST IN PATIENTS WITH ESSENTIAL HYPERTENSION: PP.8.324

Abstract

Objective: the aim of our study was to investigate the initial orthostatic reactions during active orthostatic test in patients (pts) with essential hypertension (EH). Design and method: 99 EH pts (30 M, 69F), 57,4 ± 1,1 years, grade 1 or 2. During AOT blood pressure (beat to beat) and heart rate measured continuously and non-invasively using the Task Force Monitor. Daily rhythm of systolic blood pressure (BP) was assessed by BP-24 hour monitoring with 20 min day time intervals and 40 min at night time. (BPLab, Russia). The statistical analysis was carried out by nonparametric methods of Mann-Whitney and Fisher exact test with Statistica 6. Results: In all pts average hemodynamic BP (BP-ah) amplitude was 10–30 mm Hg and was registered in the first 15 sec of orthostasis. All pts was divided into the two groups by different types of the BP reaction. In the Group I pts (n = 62) was found short-term decrease BP-ah. This type of BP reaction was more 18,0 ± 8,0 mm Hg after standing with restoration by 15 sec on 75–100% from an initial baseline level. In the Group II pts (n = 37) we found prolonged decrease BP reaction 22 ± 9 mm Hg. - initial orthostatic hypotension. In the Group II compared to group I pts was found higher day DBP (92,0 ± 1,9 vs 87,5 ± 1,5 mm Hg, p < 0,05, respectively), rate of syncope (24/37 vs 13/62, p < 0,001, respectively) and significant abnormal of nocturnal fall of SBP (8,9 ± 1,6 vs 12,4 ± 1,1; p < 0,05, respectively). All groups was not different by left ventricular mass index (169,9 ± 6,1 vs 169,4 ± 5,01; p = 0,5, respectively). Conclusions: In the EH pts with prolonged decrease BP reaction was found significant association high rate syncope and disturbance of circadian BP rhythm.