Abstract. Arterial hypertension is an important public health problem worldwide due to its high incidence and associated risks of cardiovascular and renal diseases such as coronary heart disease, cerebrovascular disease, chronic kidney disease. The level of blood pressure is the main indicator of hypertension treatment effectiveness and leading cardiovascular risk factor. Blood pressure is one of the most dynamic physiological parameters, which is characterized by continuous and significant changes beat-to-beat, over 24 h, day-to-day, and visit-to-visit. Under physiological conditions, these blood pressure variations are mostly represent a response to environmental stimulation aimed at maintaining cardiovascular homeostasis. However, a persistent increase in the blood pressure variability may be the result of pathological changes in the mechanisms of cardiovascular regulation, which leads to alterations in cardiovascular system functioning with the subsequent development of cardiovascular diseases and complications. The phenomenon of blood pressure variability has been known for a long time. It was first described by the English physiologist Stephen Gales in 1733, and its assessment in clinical conditions became possible at the end of the 19th – beginning of the 20th century, after the invention of the sphygmomanometer and the introduction of non-invasive blood pressure measurement using the Riva-Rocci and Korotkov methods. Historically, blood pressure variability has been viewed as a random factor caused by measurement error, which prevents accurate blood pressure measurement. Вlood pressure variability was considered the so-called «background noise», which was not given any importance and tried to overcome with the help of improving monitoring. However, already at the end of the last century, the discussion of the clinical significance of this indicator in patients with hypertension began. The clinical significance and prognostic implications of blood pressure variability have been demonstrated by a series of clinical and population-based studies conducted in recent years, in which elevated blood pressure variability was associated with a higher risk of target organ damage, cardiovascular events, cardiovascular and total mortality independently of blood pressure level. The review presents modern concepts of blood pressure variability, its classification, and assessment methods. The pathogenetic significance of short-term BP variability in patients with arterial hypertension is reviewed, with a discussion of the available evidence regarding the significance of short-term blood pressure variability in cardiovascular risk stratification.

Introduction. Blood pressure variability is a significant prognostic factor and an independent predictor of cardiovascular disease and mortality in patients with arterial hypertension. Objective. The objective of our study was to perform a comparative analysis of blood pressure variability indices in patients with hypertension and healthy volunteers. Materials and methods. 172 patients with arterial hypertension and 22 healthy volunteers took part in the study. All study participants underwent daily BP monitoring, based on the results of which short-term blood pressure variability was assessed. The results. In this open, non-randomized, single-point study, we first performed a comparative analysis of short-term BP variability in patients with hypertension and healthy volunteers. Currently, there is no generally accepted consensus regarding which of the proposed indices of BP variability is more informative. Therefore, in order to objectify the obtained data, we calculated several of the most widely used indices of short-term BP variability. In the main group all indices, SBP as well as DBP, were higher compared to the control group. However, the statistical significance of this difference was confirmed only for some, not for all indices. Conclusions. According to the results of the analysis of SD, SDw, CV, SV and ARV indices, a higher variability of blood pressure was established in patients with arterial hypertension compared to that in healthy volunteers. On the other hand, convincing data on the diagnostic informativeness of the CV index in the assessment of blood pressure variability were not obtained in this study.

Annotation. Short-term blood pressure (BP) variability (VAR) is an independent risk factor in patients with hypertension. Overweight and obesity are considered to be some of the factors influencing BP VAR. The aim of the study was to study the effect of overweight and obesity on the parameters of short-term BP VAR in patients with hypertension. The study involved 111 patients with hypertension, who were divided into three groups depending on the body mass index (BMI) - normal weight, overweight and obesity. All patients underwent 24-hour blood pressure monitoring (ABPM), the results of which were used to assess short-term BP VAR. Statistical analysis of the results was carried out using Microsoft Excel spreadsheets and the STATISTICA 5.5 program. Most of the studied short-term BP VAR parameters were the highest in the group of obese patients. It was established that there is a positive relationship between BMI and short-term BP VAR parameters. Overweight and obesity must be considered as contributing factors to increased BP variability.

Цель работы-определить степень влияния различных режимов гипотензивной терапии на достижение целевых значений и показатели вариабельности артериального давления у пациентов с артериальной гипертензией.

A clinical case of general somatic complaints in 47 y.o. female, presenting for several years has described. Patient F., presents with uncertain complaints of general character – tiredness, general weakness, loss of energy. During the biennium was examined and treated by gynecologist, endocrinologist, cardiologist, gastroenterologist with no benefit. Anamnesis vita is significant for uterine fibroid. After thorough interviewing was found that patient was done ECG, EchoCG, gastroscopy, thyroid tests but no CBC, urinalysis, general biochemical panel during this two years. The CBC results were stunning and gave answers to all questions.