cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1153Research ArticleКЛИНИЧЕСКИЕ ИССЛЕДОВАНИЯCLINICAL STUDIESФакторы, влияющие на выраженность различий между клиническим и амбулаторным артериальным давлениемFactors influencing the difference between office and ambulatory blood pressure measurementsАндрееваГ. Ф.AndreevaG. F.

Москва, тел.: (495) 627-04-42

Moscow

ДеевА. Д.DeevA. D.

Москва, тел.: (495) 627-04-42

Moscow

ГорбуновВ. М.GorbunovV. M.

Москва, тел.: (495) 627-04-42

Moscow

Государственный научно-исследовательский центр профилактической медициныState Research Center for Preventive Medicine200920022009816774Copyright © Андреева Г.Ф., Деев А.Д., Горбунов В.М., 20092009Андреева Г.Ф., Деев А.Д., Горбунов В.М.Andreeva G.F., Deev A.D., Gorbunov V.M.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://cardiovascular.elpub.ru/jour/article/view/1153Цель

Цель. Определить психологические предикторы и показатели качества жизни (КЖ), которые влияют на выраженность различий между клиническим и амбулаторным артериальным давлением (АД), оценить воздействие длительной антигипертензивной терапии на этот показатель.

Материал и методы

Материал и методы. Анализировали базу данных 8 исследований со сходным дизайном — результаты обследования 204 больных артериальной гипертензией (АГ), которые принимали дилтиазем, амлодипин, бетаксо-лол, моксонидин, эналаприл, лизиноприл, метопролол, телмисартан в течение 1—3 мес. Средний возраст пациентов — 53,2±8,7 года, средняя продолжительность АГ — 10,6±8,6 лет. До и после лечения проводили суточное мониторирование АД (СМАД), оценивали КЖ и психологический статус (ПС) больных.

Результаты

Результаты. Все препараты достоверно снижали систолическое и диастолическое АД (САД и ДАД). Были выявлены: обратные корреляционные связи между показателем разности клинического и амбулаторного АД и шкал IV и Н опросника КЖ, шкал F и 6 опросника для оценки ПС; прямые — между показателем разности клинического и амбулаторного АД и шкал 3, 4, F, 7 опросника для оценки ПС. Прием метопролола уменьшал разность между клиническим и амбулаторным АД: для САД — с 12,6±2,8 до 0,8±2,8 мм рт.ст., а для ДАД — с 10,4±1,8 до 3,0±1,8 мм рт.ст. Амлодипин снизил этот показатель для САД с 11,9±3,0 до 3,8±3,0мм рт. ст.

Заключение

Заключение. Разность между клиническим и амбулаторным АД повышается при увеличении показателей шкал 3, 4, К, 7 опросника ПС; снижается при увеличении показателей шкал F и 6 опросника ПС и шкалы IV и Н опросника КЖ. Из всех представленных антигипертензивных препаратов только монотерапия метопро-лолом и амлодипином достоверно снижала показатель, характеризующий разницу между клиническим и амбулаторным АД.

Aim

Aim. То identify psychological predictors and quality of life (QoL) indicators affecting the difference between office and ambulatory blood pressure (BP), as well as the effects of long-term antihypertensive treatment on this difference.

Material and methods

Material and methods. The database for 8 studies with similar design was analysed, including the data on 204 patients with arterial hypertension (AH), who took diltiazem, amlodipine, betaxolol, moxonidine, enalapril, lisinopril, metopro-lol, ortelmisartanfor 1—3 months. Mean age ofthe participants was 53,2±8,7 years, mean AH duration — 10,6±8,6 years. At baseline and after the treatment end, 24-hour BP monitoring (BPM), QoL and psychological status (PS) assessment were performed.

Results

Results. All medications significantly reduced systolic and diastolic BP (SBP, DBP). The office-ambulatory BP difference negatively correlated with QoL scales IV and H, as well as with PS scales F and 6, being positively correlated with PS scales 3, 4, F, and 7. Metoprolol therapy reduced the office ambulatory BP difference: for SBP — from 12,6±2,8 to 0,8±2,8 mm Hg, for DBP — from 10,4±1,8 to 3,0±1,8 mm Hg. Amlodipine reduced this parameter for SBP from 11,9±3,0 to 3,8±3,0 mm Hg.

Conclusion

Conclusion. The office-ambulatory BP difference increased when PS scales 3, 4, K, and 7 increased, and decreased when PS scales F and 6 or QoL scales IV and H decreased. Out of all antihypertensive medications studied, only metoprolol and amlodipine monotherapy significantly reduced the office-ambulatory BP difference.

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The authors declare that there are no conflicts of interest present.