Arterial hypertension in patients with systemic connective tissue diseases and hemorrhagic vasculitis

Abstract

Aim. To study the specific features of 24-hour blood pressure (BP) profile and its association with plasma renin activity in patients with systemic connective tissue diseases and hemorrhagic vasculitis (HV). Subjects and methods. One hundred patients aged 22 to 58 years, including 45 patients with systemic lupus erythematosus (SLE), 25 with scleroderma systematica (SDS), and 30 with HV, were examined. A control group included 30 healthy individuals. 24-hour BP profile, renal function, and plasma renin activity were studied. Results. Arterial hypertension (AH) was revealed in 53% of patients. AH occurred in 62% of patients with SLE, in 40% of those with SDS, and in 50% of those with HV. In patients with systemic connective tissue diseases and HV, the 24-hour BP profile was characterized with increases in the mean values and indices of pressure load and with a predominance of subjects with inadequate decreases in nocturnal BP (non-dippers), and with the higher values of its variability in the presence of elevated plasma renin concentrations in patients with SLE. In all the patients, the elevation of BP and its circadian dynamics depended on the renal functional status that correlated with the activity of a systemic inflammatory process. Conclusion. The patients with systemic connective tissue diseases and HV were found to have prognostically poor types of 24-hour BP profile (night-peaker, non-dipper), the magnitude of which elevation depended on renal function and plasma renin activity.

Keywords

• arterial hypertension
• 24-hour blood pressure profile
• systemic lupus erythematosus
• scleroderma systematica
• hemorrhagic vasculitis