[Impact of manual-physical correction method on aerobic metabolism processes in patients with essential arterial hypertension].

Essential arterial hypertension (EAH) is a chronic non-communicable disease (CNCD), that develops in parallel with other pathologies of the CNCD group, the presence of which is promoted by hypodynamia with consequent disturbance of aerobic energy supply processes. These disorders include, in particular, degenerative-dystrophic processes of the locomotor system, comprising of the cervical spine. In turn, development of these processes can additionally worsen hemodynamics with disturbance of the oxygen transfer processes. Thus, comprehensive exposure on all the components of EAH pathogenesis seems logical. The author's method of manual-physical correction developed by A.Yu. Shishonin is one of the therapy techniques, including such focus.

Objective: To evaluate the impact of manual-physical correction method by A.Yu. Shishonin on aerobic metabolism processes.

Material and methods: The study group included 60 patients (mean age 46.0±8.0 years) with EAH and significant manifestations of cervical osteochondrosis, including disturbances of the vertebrobasilar blood flow of different severity. All patients had high normal arterial pressure (AP) (pre-hypertension) or stage 1 EAH. The control group included 22 patients (mean age 52.6±4.9 years) with EAH without signs of target organ damage. Patients of the study and control groups had persistent dyscompliance in regard to prescribing pharmacotherapy. EAH was the major disease in patients of the study group, they were treated with the use of A.Yu. Shishonin's method. Patients of the control group were at the clinic for other nosologies, treatment of which included non-pharmaceutical correction methods, while EAH was a concomitant disease requiring hemodynamic indicators' control without performance of targeted therapy. Investigation of aerobic metabolism processes and hemodynamics in the study and control groups was carried out during the maximum gradually increasing exercise testing with gas analysis (ergospirometry).

Results: The method of manual-physical correction, without significant influence on the aerobic capacity (VO_2max), has significantly improved aerobic efficiency (increase of oxygen consumption at the level of anaerobic exchange threshold from 72.15±5.39 to 84.84±5.40% of VO_2max has been noted; p<0.001), cardiovascular compliance (increase of oxygen consumption per one cardiac beat from 14.99±4.24 to 16.83±3.91 ml; p<0.05) and reduced the pronouncement of hypertensive response to exercise (peak systolic AP before treatment 202.92±17.27 mm Hg versus 184.64±15.16 mm Hg after therapy; p<0.001) in patients of the study group.

Patients of the control group also had no significant aerobic capacity dynamics (VO_2max), as well as no significant change in aerobic efficiency and hemodynamics indicators (peak systolic AP before treatment 204.01±10.12 mm Hg versus 205.35±9.94 mm Hg after therapy; p>0.05).

Conclusion: A.Yu. Shishonin's method of manual-physical correction has an impact on oxygen metabolism, mainly through improvement of aerobic efficiency of energy supply processes, improvement of cardiovascular compliance and reduction of hypertensive reactions to exercise pronouncement.