Special features of microcirculatory disorders in patients with comorbid hypertension and rheumatoid arthritis

Abstract

Background. During the recent years, there has been a steadily growing interest in the problems of microcirculatory disorders (MD) in patients with cardiological and rheumatological profile that is determined by a significant role of microcirculatory in the pathogenesis of these diseases.Objective. Analysis of the MD special features in patients with hypertension (HTN) and rheumatoid arthritis (RA).Design and methods. Patients matching the inclusion criteria by age (58,6 ± 6,4 years), debut (aged 45–64 years) and RA experience (7,2 ± 2,1 years) and HTN duration (11,2 ± 1,6 years) were divided into three groups: I group — 277 patients with stage II HTN; II group — 142 patients with stage II HTN and RA (in clinical and laboratory remission); group III — 112 patients with stage II HTN and RA (in clinical and laboratory exacerbation). The study of the microcirculatory bed was performed on an outpatient basis by laser Doppler flowmetry according to a standard technique. Results. Microcirculatory bed analysis in patients with HTN and RA showed the variability of indicators depending on gender characteristics, body weight and microcirculatory type. The study of the amplitude-frequency spectrum in women with stasis, in men with spastic and normocirculatory types of microcirculation showed an increase in neurogenic tone, endothelial activity and some decrease in the amplitude of oscillatory processes at the periphery.Conclusions. In patients with HTN and RA, changes at the microcirculatory level were determined, they manifested by an increase in adrenergic tone, spastic phenomena, endothelial activation, some decrease in blood flow variability and more pronounced vasomotor dysfunction that is not only the result of RA presence but its activity. RA in this situation could be regarded as a surrogate marker for the unfavorable course of HTN.