SIGNIFICANCE OF THE AUTONOMOUS SYSTEM CONDITION AND BLOOD PRESSURE VALUES IN PATIENTS WITH ARTERIAL HYPERTENSION IN THEIR OUTPATIENT SURVEILLANCE WITH THE AIM OF REPEATED HOSPITALIZATION RISK ASSESSMENT
https://doi.org/10.15829/1728-8800-2014-5-8-13
Abstract
Aim. To evaluate the relation of the autonomous system functioning with circle-round characteristics of blood pressure (BP) in patients with arterial hypertension (AH) depending on repeated hospitalizations.
Material and methods. Totally 60 AH patients studied with the Wein A. M. Questionnaire, Bayevsky’s cardiointervalography, ambulatory BP monitoring and their physical activity and sleep quality.
Results. In AH patients, that had repeated hospitalizations there is 15-16% increase of the mean clock-round BP and increase of time indexes, of variability and values of morning BP increase with the prevalence of “non-dipper” pattern. Also for these patients, “vegetative” complaints were more common, mostly on sleep disorders, which was evidenced by a decrease of sleep effectiveness and vegetative dysbalance. There was correlation of daytime physical activity with more prominent nocturnal systolic BP decrease. By multifactorial analysis, repeated hospitalizations were related to clock-round BP, age, mean BP, sleep effectiveness and presence of vegetative dysbalance.
Conclusion. It is necessary to include the factors revealed for risk assessment of AH destabilization and repeated hospitalizations risk.
About the Authors
A. P. Ivanov
Tver Cardiovascular Dispensary, Tver
Russian Federation
tel.: (4822) 52-05-05; fax: (4822) 52-84-21
Russian Federation
tel.: (4822) 52-05-05; fax: (4822) 52-84-21
K. A. Maltsev
Tver Cardiovascular Dispensary, Tver
Russian Federation
Russian Federation
I. A. Elgardt
Tver Cardiovascular Dispensary, Tver
Russian Federation
Russian Federation
N. S. Sdobnyakova
Tver Cardiovascular Dispensary, Tver
Russian Federation
Russian Federation
References
1. Mancia G, Laurent S, Agabiti-Rosei E, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertension 2009; 27 (11): 2121-58.
2. Kobalava ZhD, Коtovskaja YuV, Moiseev VS. Arterial hypertensia. Keys to diagnostics and treatment. M.: GJeOTAR-Media 2009; 864. Russian (Кобалава Ж. Д., Котовская Ю. В., Моисеев В. С. Артериальная гипертензия. Ключи к диагности- ке и лечению. М.: ГЭОТАР-Медиа 2009; 864 с).
3. Hansen TW, Li Y, Boggia J, et al. Predictive role of the nighttime blood pressure. Hypertension 2011; 57: 3-10.
4. Ohkubo T, Hozawa A, Yamaguchi J, et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. J Hypertension 2002; 20: 2183-9.
5. Smith T, Gildeh N. The Montreal Cognitive Assessment: validity and utility in a memory clinic setting. Can J Psychiatry 2007; 52: 329-32.
6. Hughes JW, Kobayashi I, Deichert N. T. Ethnic differences in sleep quality accompany ethnic differences in night-time blood pressure dipping. Am J Hypertension 2007; 20: 1104-10.
7. Rogoza AN. Daily monitoring of arterial pressure (on materials of methodical recommendations of ESH 2003). Functional diagnostics 2004; 4: 29-44. Russian (Рогоза А. Н. Суточное мониторирование артериального давления (по материалам методических рекомендаций ESH 2003). Функциональная диагностика 2004; 4: 29-44).
8. Jones SC, Bilous M, Winship S, et al. Validation of the OSCAR 2 oscillometric 24-h ambulatory blood pressure monitor according to the International Protocol for the validation of blood pressure measuring devices. Blood Press Monit 2004; 9: 219-23.
9. Goodwin J, Bilous M, Winship S, et al. Validation of the Oscar 2 oscillometric 24-h ambulatory blood pressure monitor according to the British Hypertension Society protocol. Blood Press Monit 2007; 12: 113-7.
10. De la Sierra A, Segura J, Gorostidi M, et al. Diurnal blood pressure variation, risk categories and antihypertensive treatment. Hypertens Res 2010; 33: 767-71.
11. Ben-Dov IZ, Kark JD, Ben-Ishay D, et al. Predictors of all-cause mortality in clinical ambulatory monitoring unique aspects of blood pressure during sleep. Hypertension 2007; 49: 1234-41.
12. Bayevsky PM, Bersenev AP. Assessment of adaptation opportunities of an organism and risk of development of diseases. M., Medicine 1997; 265 p. Russian (Баевский Р. М., Берсенева А. П. Оценка адаптационных возможностей организ- ма и риск развития заболеваний. М., Медицина 1997; 265 с).
13. Bayevsky RM. Analysis variability of a warm rhythm when using various electrocardiographic systems: Methodical recommendations. M, 2002; 53 p. Russian (Баевский Р.М. Анализ вариабельности сердечного ритма при использовании различных электрокардио- графических систем: Методические рекомендации. М., 2002; 53 с).
14. Konradi AO. Updating of the European recommendations about arterial hypertension 2009 – that appeared new and what new it was necessary to refuse. Arterial Hypertension 2010; 1 (16): 43-4. Russian (Конради А.О. Обновление Европейских рекомендаций по артериальной гипертензии 2009 – что появилось нового и от чего нового при- шлось отказаться. Артериальная гипертензия 2010; 1 (16): 43-4).
15. Muxfeldt ES, Cardoso CR, Salles GF. Prognostic value of nocturnal blood pressure reduction in resistant hypertension. Arch Intern Med 2009; 169: 874-80.
16. Boggia J, Li Y, Thjis L, et al. for International Database on Ambulatory blood pressure monitoring in relation to Cardiovascular Outcomes (IDACO) investigators. Prognostic accuracy of day versus night ambulatory blood pressure: a cohort study. Lancet 2007; 370: 1219-29.
Review
For citations:
Ivanov A.P., Maltsev K.A., Elgardt I.A., Sdobnyakova N.S. SIGNIFICANCE OF THE AUTONOMOUS SYSTEM CONDITION AND BLOOD PRESSURE VALUES IN PATIENTS WITH ARTERIAL HYPERTENSION IN THEIR OUTPATIENT SURVEILLANCE WITH THE AIM OF REPEATED HOSPITALIZATION RISK ASSESSMENT. Cardiovascular Therapy and Prevention. 2014;13(5):8-13. (In Russ.) https://doi.org/10.15829/1728-8800-2014-5-8-13
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