Microcirculation in elderly patients with arterial hypertension

Aim. То study microcirculation (МС) and its role in arterial hypertension (AH) pathogenesis among elderly patients.

Material and methods. The maingroup (MG) included 39 patients with Stage I-III AH (meanage 75,1±0,8 years). All participants underwent rheovasography (RVG), conjunctival biomicroscopy, and Doppler ultrasound ofbrachial and femoral arteries. The control group (CG) included 24 healthy people (mean age 27,7±1,5 years). Velocity offast, slow and volume blood filling (FFV, SFV VFV), as well as pulse wave velocity (PWV), was measured

Results. In patients with Stage I-II AH, forearm FFV was decreased, but VF remained normal, due to increased blood filling time (BFT). Stage III AH was characterised by reduced VF in fast and slow phases. CalfVF, independently of AH stage, was similar to that in controls, while SF was 2,5 times lower, due to reduced blood filling velocity and unchanged BFT In elderly AH patients, microcirculation vessels are filled normally in the FF phase, while VF is decreased in the SF phase, due to reduced blood influx from large arteries. PWV did not affect VF The timing of the additional wave at main RVG dicrote coincided with additional oscillations at Doppler ultrasound. Therefore, this wave could be explained by diastolic aortal damping of the small pulse wave.

Conclusion. In elderly patients with early AH stages, forearm VF remained unchanged, with changes only in time and volume parameters, while Stage III AH was characterised by reduced VF CalfVF, due to SF phase, is reduced regardless of the AH stage. Unchanged VF in the FF phase and reduced VF in the SF phase demonstrated that arteriole spasm could not be an explanation of increased peripheral vessel resistance and elevated blood pressure.

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