Российский кардиологический журнал (May 2018)
SPECIFICS OF NEUROHUMORAL ACTIVITY AND CLINICAL PRESENTATION OF MASKED ARTERIAL HYPERTENSION IN YOUNG MALES
Abstract
Aim. To assess the neurohumoral state, specifics of clinical presentation, prevalence and prominence of cardiovascular and behavioral risk factors in males of young age with masked arterial hypertension (MAH).Material and methods. To the full coverage screening study, 643 participants included, age 18-30 y. o. (mean age 22). Complete clinical and laboratory, instrumental assessments performed, with analysis of neurohumoral activity by the levels of adrenaline, noradrenaline, angiotensin II. All participants were selected to groups: MAH (n=61), manifest AH (n=46), normotonics (n=536). Diagnostics of MAH was done in case of positive test of 30 second respiration pause and 24 hour blood pressure (BP) monitoring.Results. In males, MAH was found in 9,5% cases, manifest AH in 7,1%, normotonia in 83,4%. In MAH and manifest AH participants the level of adrenaline was higher than in normotonics: 4,55 pM/L [3,53; 5,1], 6,25 pM/L [4,75; 8,65] and 2,1 pM/L [1,2; 4,5], respectively. Males with MAH had almost 2 times higher level of noradrenaline (19,5 pM/L [18,8; 22,8]) comparing to “normotonics” (8 pM/L [6; 12,1]) and 1,5 times higher than in manifest AH (13,1 pM/L [11,5; 14,4]). Angiotensin II assessment showed that in MAH males it was higher (18,5 pM [15,75; 21,9]), than in normotonics (15,7 pM [13;18,3]), but lower than in manifest AH (20,15 pM [18,9; 21,9]). Food related behavior assessment as of a factor of sodium overconsumption, the higher values were found in MAH patients and in manifest AH (50% and 50%) comparing to normotonics (25%). Early age of smoking beginning found in 28% of MAH males, more prevalent than in normotonics (24%) and manifest AH (15%).Conclusion. In young males MAH is revealed more often than manifest AH. Development of MAH in young males is related to hypersympathicity with raised catecholamines level, disordered 24 hour rhythm “non-dipper”, disorder of BP variability and higher smoking level, than in normotonics.
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