Daily variability of arterial stiffness of patients with arterial hypertension depending on the category of cardiovascular risk

Abstract

Purpose. The study of the daily variability of arterial stiffness indicators, depending on the category of cardiovascular risk. Materials and methods. The study consistently included patients with essential hypertension who were admitted to the cardiology department of the Volga district medical center from November 1, 2015 to October 1, 2017. The study involved 134 patients with an average age of 52±1 years. Depending on the category of total cardiovascular risk, the patients were divided into 3 groups from I (lowest risk) to III (highest risk). The analysis was carried out on ABPM for 12–14 days (BPLab system of “Peter Telegin” firm). Determined: glomerular filtration rate (GFR), the thickness of the intima-media of the common carotid arteries, analysis of the lipid spectrum. For statistical analysis of clinical and instrumental data, a T-criterion for independent samples was used and an ANOVA analysis was performed. A correlation analysis was performed. Results. Patients of group III had the highest level of av. SBP (рI–III=0.010; pII–III=0.020) and mean pulse BP (PBP) (рI–III=0.002; pII–III=0.002), also more unfavorable the indicators cALALx (pI–II=0.025; рI–III=0.004), varAlx (рI–III=0.004) and av. ASI (рI–III=0.034). When comparing the data of patients of groups II and III, adjusted for gender and age, it was found that statistically significant differences between the groups of varPAD (pII–III=0.008), AASI (рI–III=0.043), varAlx (pII–III=0.049), as well as a pronounced tendency for varASI (pII–III=0.050). Markers of target organ damage (TIM, LVML, GFR) were more pronounced in the high-risk group. As the risk group increased, the level of HDL decreased (рI–III=0.002; pII–IIII=0.0001), the level of TG increased (рI–III=0.007; pII–III=0.009) and the CA (рI–III=0.015). The total cholesterol level was lower in patients of group III compared to group II (pII–III=0.004). Statistically signifi nt relationships of arterial wall stiffness indicators with age were found: crAlx (0.467, p<0.001), varAlx (0.272, p<0.01), cpASI (0.227, p<0.01), varASI (0.407, p<0.001). In addition, women showed significant correlations of medium and high strength between age and mean values of mean SPD (r = 0.490, p<0.05), varPAD (r=0.540, p<0.05), avAS (r=0.460, p<0.05) and varASI (r=0.620, p<0.05). VarASI and WedSASI were most closely associated with the level of SRSAD and SRPAD. Only cASI was associated with GFR, and only varASI was associated with the parameters of the lipid spectrum (HSLPVP, TG, KA and LVMI. Conclusion. The most statistically significant dynamics was observed when evaluating varASI, which varied in the sequence I gr. <II gr. < III gr. Corrected by sex and age, the analysis showed a greater variability in arterial stiffness in high-risk patients.