Medičnì Perspektivi (Jun 2022)
Doppler and clinical characteristic of cephalgia in patients with arterial hypertension during intermittent fasting
Abstract
There were examined 142 patients with recurrent headache (cephalgia) and arterial hypertension, a mean – 49.26±1.33 years, of whom 69 men, 73 women who used intermittent fasting (patients spent 24 hours without food, 1 time per week, four repetitions). The control group consisted of 32 people of comparable age without hypertension (n=32; mean age 51.0±1.99 years). The purpose of the study was to increase the effectiveness of diagnostic and therapeutic methods in patients with hypertension and headache by establishing the meaning and peculiarities of the influence of intermittent fasting on headaches, neck carotid and intracranial circulation. There were 51 (35.9%±4.03) patients aged 25-44 years’; 45-59 years – 42 (29.58%±3.83) patients; 60-75 years – 49 (34.51%±3.99) patients. It was found that the structural pathology of the main arteries of the head consisted mainly in the thickening of the intima-media from 0,8 to 1,4 mm in 62.7% at the age of 25-44 years; in 71,4% at the age of 45-59; in 51% at the age of 60-75 years. Local thickenings in the bifurcation zone from 1.5 mm without hemodynamically significant stenosis were found in 9.8% at the age of 24-44 years, in 28.6% at the age of 45-59 years and in 49% at the age of 60-75 years. Statistical differences in linear circulatory velocity between the control group and the group of patients were significant already at the age of 25-44 years, for peak systolic velocity in the internal carotid artery (78.03±4.67 vs. 61.0±2.54 in control, p<0.05). At the age of 45-59 years, linear circulatory velocity affected all carotid and vertebral arteries, as in the group aged 60-75. The effect of intermittent fasting on aged hemodynamics consists mainly in changes of velocity of flow in arteries with better results in younger patients. Changes in the elastic-tonic characteristics of the main arteries of the head according to the index of resistance (index was 0.72±0.01 for common carotid artery and 0.63±0.01 after intermittent fasting in patients at the age of 25-44 years; 0.78±0.01 before and 0.67±0.01 after at the age of 60-75 years were revealed). The use of the intermittent fasting method caused mainly an increase in diastolic flow rates in the main arteries (with age dependences) and a decrease in systolic velocity in the age group 25-44 years. The pathophysiological interpretation of such changes is in the reducing the resistance, values of the main arteries of the head.
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