NEW APPROACH TOWARDS THE INTEGRAL ASSESSMENT OF CARDIOVASCULAR STATUS IN PATIENTS WITH ARTERIAL HYPERTENSION

Abstract

Aim. To assess the potential of the integral assessment of cardiovascular system status in patients with arterial hypertension (AH), based on the evaluation of the parameters of microcirculation (non-invasive digital capillaroscopy) and macrocirculation (pulse wave velocity (PWV) and endothelial function).Material and methods. The study included 188 people aged 40 years and older:32 patients with systolic blood pressure (BP) levels 120–139 mm Hg (“PreAH”group), 36 patients with Stage 1–2 AH (“AH” group), and 85 AH patients whoachieved target BP levels due to antihypertensive therapy (“Treated AH” group). Thecontrol group included 35 healthy volunteers, without any signs or symptoms ofcardiovascular disease (“Healthy” group). All participants underwent clinical andlaboratory examination, including office BP measurement, 24-hour BP monitoring,and echocardiography, the assessment of nailfold microcirculation, pulse wavevelocity, endothelial function, as well as the measurement of BP and heart rate.Results. There was an increase in remodelling coefficient (Cv/a) in the groups“PreAH”, “AH”, and “Treated AH”, compared to the “Healthy” group. PWV levels weresignificantly higher in “PreAH” and “Treated AH” groups than in the “Healthy” group.Based on micro- and macrocirculation parameters assessed, the integral index ofcardiovascular status was calculated. The values of this index were significantly higher in the “AH” group. Effective antihypertensive treatment was associated with areduction in these values.Conclusion. Based on the assessment of a range of micro- and macrocirculationparameters in AH patients, the integral index of cardiovascular status had beendeveloped.This index satisfactorily reflects the dynamics of micro- and macrocirculation in treatedAH and, therefore, can be used as an indicator of effective antihypertensive therapy.The complex assessment of macro- and microcirculation provides an opportunityfor early AH detection.

Keywords

• capillaroscopy
• pulse wave velocity
• endothelial function
• integral index
• prehypertension
• arterial hypertension