Clinical and structural-functional characteristics of heart condition and elastic and muscular type-vessels, their prognostic importance for aged patients with arterial hypertension

Agafonov A.V.
Dissertation abstract
GOU VPO “Roszdrav’s Perm State Medicine Academy after E.A.Wagner” at Federal health service and social development agency
Scientific consultant: Honoured worker of science, Doctor of Medicine, Professor A.V.Tuev

Purpose: Study clinical and structural-functional characteristics of heart condition and elastic and muscular type-vessels, their prognostic importance for aged patients with arterial hypertension.

Materials and methods: 250 people were inspected. Including 222 patients with diagnosed arterial hypertension II and III stage, with different augmentation index, of high or very high risk. Arterial hypertension availability was a criterion for inspection inclusion. 161 people belonged to the group of older age arterial hypertension with age limit 55 years plus. The average patients age was 65,8 ± 8,4 years what is comparable with data acquired from modern clinical older ages arterial hypertension research.  There were build some comparison groups. 28 apparently healthy contemporaries comparable to age, sex, body mass index and a number of smokers entered on group. The second group consisted of patients with arterial hypertension 55 years plus comparable to age, IMT and a number of smokers too.
Arterial hypertension was diagnosed according to the 2nd Report issued by arterial hypertension research society experts, All-Russian cardiologists’ society and Interauthority Board for cardiovascular diseases (DAG-2, 2001). Criteria applied in this Report correspond with World Health Organization requirements of 1999.
Exception criteria: hypertension secondary nature, creatinine level above 150 mkmol/l, hypokalemia under 3,4 mmol/l, hyperurikemia above 150 mkmol/l, availability of chronic lung disease,  renal and hepatic insufficiency in case history; acute myocardial infarction, instable angina, cerebrovascular accident, heart rhythm break, anaemia, temperature rises, infectious diseases, cardiac failure III and IV FC according to NYHA, rheumatic diseases, conditions demanding hormonal and steroid therapy or anticoagulant prescription, or other pathologies that may have effect on peripheral arteries walls and their reactivity, diffusive atherosclerotic common carotid artery involvement, haemodynamically important common carotid artery stenosis and their branches, any atherosclerotic branchial artery involvement.
All the patients from older age hypertension group were divided into 2 subgroups comparable to sex and age depending on availability of systolic arterial hypertension.
Other stage: division of patients from older age hypertension group into groups depending on pulse pressure level: relatively low pulse pressure was less than 60 mmHg, relatively high – accordingly 60 mmHg and higher; groups were also comparable to sex and age.
Daily blood pressure was monitored with the use of MnSDP-2 device and software BPLab (OOO “Petr Telegin”, Russia) in accordance with specialists’ recommendations from Russian cardiologic research and production complex, Ministry of Health RF.
The following indices were determined during MAD-analysis: average and extreme values, time indices, area indices, variability of systolic and diastolic BP, average BP, double rate.
Indices were calculated both upon the average during a day and for intervals “day”-“night”.