cardiovascularКардиоваскулярная терапия и профилактикаCardiovascular Therapy and Prevention1728-88002619-0125«SILICEA-POLIGRAF» LLCcardiovascular-1784Research ArticleТЕМАТИЧЕСКИЕ СТАТЬИКлиническое значение комплексного амбулаторного мониторирования артериального давления и показателей ригидности у больных артериальной гипертонией очень пожилого возрастаClinical value of complex ambulatory monitoring of blood pressure and arterial rigidity in elderly patientsМарковаМ. А.MarkovaM. A.

Ассистент кафедры пропедевтики внутренних болезней.

Москва

Moscow

markova-maria@yandex.ruТюлькинаЕ. Е.TyulkinaE. E.

Профессор кафедры.

Москва

Moscow

КотовскаяЮ. В.KotovskayaYu. V.

Профессор кафедры.

Москва

Moscow

КобалаваЖ. Д.KobalavaZh. D.

Заведующая кафедрой.

Москва

Moscow

Российский университет дружбы народов на базе ГКБ № 64Russian People’s Friendship University, City Clinical Hospital No. 64200920082009841822Copyright © Маркова М.А., Тюлькина Е.Е., Котовская Ю.В., Кобалава Ж.Д., 20092009Маркова М.А., Тюлькина Е.Е., Котовская Ю.В., Кобалава Ж.Д.Markova M.A., Tyulkina E.E., Kotovskaya Y.V., Kobalava Z.D.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/1784Цель

Цель. Изучить клинико-диагностическое значение показателя времени распространения пульсовой волны (PTT) при суточном мониторировании (СМ) артериального давления (АД), его связь с показателями эластических свойств крупных артерий и аорты: скоростью распространения пульсовой волны между сонной и бедренной артериями (СРПВсб) и сердечно-лодыжечным сосудистым индексом (СЛСИ) у пациентов > 75 лет.

Материал и методы

Материал и методы. В исследование были включены 52 больных (20 мужчин) > 75 лет (средний возраст 79,1±3,5), с артериальной гипертонией (АГ), 15 пациентов имели в анамнезе сердечно-сосудистые осложнения (ССО): 11 перенесли инфаркт миокарда, 4 — инсульт, у 16 больных — клиника стенокардии II-III функциональных классов; 32 получали антигипертензивную терапию. Оценивали показатели СМАД и РТТ Определяли величину корригированного РТТ100-60, при систолическом АД (САД) 100 мм рт.ст. и частоту сердечных сокращений (ЧСС) 60 уд/мин. СРПВсб и СЛСИ исследовали с помощью скрининговой системы обследования сосудов VS 1000 VaSera, Fukuda Denshi, Япония.

Результаты

Результаты. В общей группе наблюдения клиническое АД 147,5±6,9/76,5±5,1 мм рт.ст.; АД24 139,6±6,7/70,7±4,6 мм рт.ст., РТТ100-60 - 161,7±6,2 мс, СРПВсб - 17,3±4,6 м/с, СЛСИ - 10,6±3,1. Достоверная обратная взаимосвязь отмечена между РТТ100-60 и уровнем САД24 (r=-0,36, p<0,05), ПАД24 (r=-0,43, p<0,01), СРПВсб (r=-0,54, p<0,01) и СЛСИ (r=-0,34, p<0,05). Группы с и без ССО были равны по возрасту, для группы без ССО характерен более редкое применение антигипертензивной терапии, повышенные цифры клинического АД — 153,5±6,9/82,5±6,3 и 136,5±3,4/71,1±3,9 мм рт.ст.; АД24 — 144,0±6,9/73,2±5,3 и 132,6±4,2/69,3±3,8 мм рт.ст., более низкие значения СРПВсб — 15,8±4 и 18,7±4,4 м/с, СЛСИ 9,7±2,4 и 11,5±3,8; высокие РТТ100-60 - 167±5,4 и 156,2±6,9 мс (p<0,05).

Заключение

Заключение. У пациентов > 75 лет с АГ РТТ100-60 при СМАД коррелирует с традиционными показателями жесткости артерий. Более низкие значения РТТ100-60 и высокие - СРПВ, отмечены в группе с анамнезом ССО.

Aim

Aim. To study the clinical and diagnostic role of pulse wave time (PWT) in 24-hour blood pressure monitoring (BPM) and its link to elasticity of larger arteries and aorta (carotid-femoral pulse wave velocity, PWVcf; cardioankle vascular index, CAVI) in patients aged over 75 years.

Material and methods

Material and methods. The study included 52 patients (20 men) aged over 75 years (mean age 79,1±3,5 years) with arterial hypertension (AH). Fifteen participants had cardiovascular events (CVE) in anamnesis: myocardial infarction, MI (n=11) or stroke (n=4). Sixteen patients had Functional Class II-III angina (n=16), and 32 received antihypertensive therapy. 24-hour BMP and PWT parameters were measured. Corrected PWT100-60 was calculated for systolic BP (SBP) 100 mm Hg and heart rate (HR) 60 bpm. PWVcf and CAVI were assessed with a screening device VS 1000 VaSera, Fukuda Denshi, Japan.

Results

Results. In all participants, clinical BP level was 147,5+6,9/76,5+5,1 mm Hg; 24-hour BPM BP level - 139,6+6,7/70,7+4,6 mm Hg; PWT100-60 - 161,7+6,2 ms; PWVcf - 17,3+4,6 m/s, and CAVI - 10,6+3,1. A sig­nificant negative correlation between PWT100-60 and 24-hour BPM SBP (r=-0,36, p<0,05), 24-hour BPM PBP (r=-0,43, p<0,01), PWVcf (r=-0,54, p<0,01) and CAVI (r=-0,34, p<0,05) was observed. Patients with and without CVE were comparable by age. CVE-free participants were characterised by lower frequency of antihypertensive therapy, higher levels of clinical BP (153,5+6,9/82,5+6,3 vs. 136,5+3,4/71,1+3,9 mm Hg), higher 24-hour BPM BP (144,0+6,9/73,2+5,3 vs. 132,6+4,2/69,3+3,8 mm Hg), lower PVWcf (15,8+4 vs. 18,7+4,4 m/s), lower CAVI (9,7+2,4 vs. 11,5+3,8), and higher PWT100-60 (167+5,4 vs. 156,2+6,9 ms; p<0,05).

Conclusion

Conclusion. In AH patients aged over 75 years, PWT100-60 correlated with traditional indices of arterial rigidity. Lower PWT100-60 and higher PWV were observed among individuals with CVE in anamnesis.

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