Blood pressure time load formation in patients with arterial hypertension without metabolic syndrome

Abstract

Relevance . The study of the daily dynamics of blood pressure in arterial hypertension both on the basis of the daily index and on the basis of the time load is a relevant task, since, these indicators are associated in the literature with stable changes in the neurohumoral regulation of the cardiovascular system in arterial hypertension . The aim of the study was to compare data of the time load in patients with arterial hypertension , depending on the nocturnal blood pressure profile, with integrative indicators of the activity of the cardiovascular system in the form of a Circadian index, a structural point of blood pressure, double product. Materials and Methods. The study included 72 patients who were treated at the City Clinical Hospital No 13 in Moscow and signed a voluntary consent to participate in the research and the processing of personal data. Inclusion criteria: arterial hypertension. Exclusion criteria: metabolic syndrome, secondary forms of arterial hypertension and concomitant pathology. Depending on the daily index (DI10% and DI10%) patients were divided into 2 groups: 1 group (N= 32): patients with arterial hypertension without nocturnal decrease in blood pressure (non-dippers and night-pickers100%); Group 2 (N = 40): patients with arterial hypertension who had a nocturnal decrease in blood pressure (dippers and over dippers 100%). All patients and members of the control group (N=15) underwent daily monitoring of blood pressure (24-hour Arterial Blood Pressure Monitoring). The data were statistically processed to determine the 5% level of significance of differences (p0.05) (Students test). In the comparative analysis of integrative indicators at day and at night, a variance analysis was applied. Results and Discussion . As a result of the study, it was found that the values of Circadian Index for blood pressure vary depending on the type of night decrease in blood pressure and the blood pressure time load, while daily index and structural point of blood pressure remain on the same level as a reflection of the hemodynamic allostasis existing in both groups. Conclusion. Reflection of the allostatic load on hemodynamics is change of values of double product and of the structural point of blood pressure compared with the control group. These changes are not associated with the peculiarities of the nocturnal blood pressure profile in patients with hypertension without metabolic syndrome.