Item condition of the autonomic nervous system in patients with hypertension stage II low additional cardiovascular risk depending on the status of smokers

Abstract

Beckground. This century is characterized by steady growth in the number of patients who have cardiac pathology combined with other factors, aggravating the disease and prognosis. High prevalence of smoking among young patients with hypertension. Research devoted to the study of influence of risk factors , including smoking, on the structural and geometric and functional changes of the heart is not enough. Aim. Explore the contribution of modifiable risk factors for smoking in a pathological process of structural and geometrical and functional restructuring infarction in hypertensive patients. Material and methods. Examined by transthoracic echocardiography 100 patients (30 smokers and 70 non-smokers) with essential hypertension stage II, 53 men and 47 women. Group of patients matched for age, sex, body mass index, level of fasting glucose, value "office" SBP, DBP, PAP, mean arterial pressure, heart rate. For data analysis methods of parametric (t-test for dependent and independent variables, ANOVA ANOVA) and nonparametric (Wald-Wolfowitz runs test, Kolmogorov-Smirnov two-sample test, Mann-Whitney U test) statistics. Differences considered statistically significant at a value of p<0,05. Results. Hypertensive patients who had smoking status, revealed significantly larger left atrial diastolic by 8.1 % (p = 0.014), systolic 10.8% (p = 0.026), the prevalence of thickness PWLVs 6.1% ( p = 0.028), the thickness IVSd 11.6 % (p = 0.004) , the thickness PWLVs 10.7 % (p = 0.034 ) LVMI 12.2% (p = 0.034) and diastolic intramyocardial stresses 13.9 % (p = 0.025 ), lengthening of the period of isometric relaxation by 33.3 % (p = 0.026 ) compared with those in non-smoking hypertensive patients. Conclusion. Modulatory effect of smoking on the pathological processes of cardiac remodeling in hypertensive patients manifested by an increase in systolic and diastolic dimensions of the left atrium, wall thickness and left ventricular mass, without an extension of the heart cavities, with an increase in diastolic left ventricular intramyocardial stresses. Restructuring in hypertensive heart under the influence of smoking creates the conditions for changes in diastolic filling of the left ventricle, with a reduction in active relaxation, increase in the contribution of late filling and prolongation of isometric relaxation.

Keywords

• arterial hypertension
• autonomic nervous system
• blood pressure
• smoking