The Relationship between the Parameters of Blood Pressure Variability and Arterial Wall Stiffness in Patients with Arterial Hypertension

Abstract

The purpose of the research was to study the significance of blood pressure variability (BPV) in the assessment of arterial stiffness (AS) in patients with arterial hypertension (AH), and their possible relationship with the indicators of structural and functional remodeling of the myocardium, serum lipid spectrum, and homeostasis system. Materials and Methods: A total of 138 patients (mean age of 56.7±12.8) with AH were examined. All patients were twice divided consecutively into two groups: one on the basis of age (the age groups ≥60 years and 0.05). In the ISH subgroup, average 24-h DBP was significantly lower than in the SDH subgroup: 74.5±4.8 mmHg and 87.4±10.9 mmHg, respectively (P=0.000). All patients underwent the following examinations: assessment of traditional risk factors, physical examination, clinical and biochemical laboratory methods, 12-lead ECG, echocardiography, 24-hour ABPM, assesment of the AS parameters, and measuring the carotid-femoral pulse wave velocity (PWVcf). Results: The age group ≥60 years is characterized by a significant increase in AS compared to the age group <60 years. In the age group ≥60 years, the levels of daytime and nighttime pulse pressure (PP) and the variability of daytime SBP and PP were significantly higher than in the age group <60 years. The increase in AS is associated with an increase in the daytime and nighttime SBP and PP, with the variability of daytime SBP and PP. The relationship between AS and the variability of SBP and PP, as well as the morning SBP RoR, was revealed. An increase in AS is also associated with an increase in the degree of the left ventricular myocardium remodeling. In ISH patients, compared to SDH patients, a significant increase in AS was found. ISH patients were characterized by a greater variability in the daily SBP and PP. In the SDH subgroup of patients, an increase in fibrinogen level was revealed. The level of cardiovascular risk (CVR) in AH is associated with an increase in the daily variability of SBP, DBP and PP. Conclusion: In a comprehensive examination of patients with AH, it is advisable to perform ABPM with simultaneous determination of AS parameters. The increased AS and BPV mark the patients belonging to a higher CVR group.

Keywords

• arterial hypertension
• isolated systolic hypertension
• ambulatory blood pressure monitoring
• arterial stiffness
• pulse wave velocity