The objective of rhe study was to identify the features of the daily sinus rhythm variability (HRV), affecting the manifestations of the antihypertensive effect of b-adrenergic blockers and to establish the connection of this effect with the dynamics of the daily HRV. Material and methods. 52 patients with grade 1-2 degree essential arterial hypertension (32 to 60 years old - 21 men and 31 women) underwent general clinical and functional examination using bifunctional monitoring of ECG and blood pressure before and after treatment with carvedilol, nebivolol and bisoprolol. Monitor daily mean systolic (MSAD) and diastolic (MDAD) pressure were assessed in comparison with the distribution of heart rate during the day and the amount of HRV corresponding to different ranges of heart rate. Results. The initial average group values of the MSAD and MDAD parameters and the HR distribution during the day were equal in groups in groups with achieved (ABP) and not achieved (NABP) target blood pressure levels. Achievement of target levels of mean daily blood pressure (SBP≤130 mm Hg and DBP≤80 mm Hg) is associated with the initial quantitative parameters of daily HRV, corresponding to different ranges of HR. Differences between HRV in the ABP and NABP groups appear in the HR ranges of less than 75 beats/min: the initial values of HRV are greater in the ABP group than in the NABP group. In the range of heart rates 69-75 beats/min, the differences in HRV values become significant. As a result of therapy, the initially high mean group values of HRV in the ABP group decrease, while in the NABP group they remain unchanged. Conclusion. With initially high values of HRV in the heart rate range of 69-75 beats/min, the likelihood of a decrease in blood pressure to the target level during treatment with b-adrenergic blockers increases

Aim. Identify in patients with arterial hypertension (AH) the peculiarities of the effect of various classes of antihypertensive drugs on the daily variability of sinus rhythm (HRV). Material and methods. We examined 29 patients with grade 1-2 degree essential AH aged 32 to 60 years (16 men and 13 women) using bifunctional monitoring of ECG and blood pressure before and after treatment with bisoprolol, amlodipine, lisinopril and a combination consisting of lisinopril and amlodipine. We evaluated the hypotensive effect of the drugs associated with the distribution of heart rate during the day and the amount of HRV corresponding to different ranges of heart rate. Results. In cases where the antihypertensive effect (AE) of bisoprolol was expressed, the initial HRV values in the heart rate ranges close to 75 beats/min were significantly greater than in the absence of effect. After treatment, in the presence of AE of bisoprolol, a significant decrease in HRV parameters was observed in these heart rate ranges. AE of amlodipine was associated with an initially high heart rate concentration in the ranges close to 75 beats/min. The efficacy of lisinopril and the combination of lisinopril with amlodipine was associated with an initially high heart rate concentration in the range 69-83 beats/min and its decrease during the treatment. Conclusion. With a random set of patients and a random choice of drugs for the treatment of AH, the presence and absence of an antihypertensive effect was accompanied by statistically significant differences in the initial values and in the dynamics of HRV parameters.

Aim. To study the relationship of the initial clinical and functional state of patients with arterial hypertension (AH) with the dynamics of daily indices of blood pressure (BP) and sinus rhythm on antihypertensive therapy. Materials and methods. 38 patients were examined (general clinical examination, electrocardiography, echocardiography, daily bifunctional monitoring with the determination of weighted average rhythmogram variations - WARV, clinical and biochemical analysis of blood, glycated hemoglobin, thyroid hormones) and distribyted according to the use of hypotensive drugs of main classes and combined therapy AH. Dynamic monitoring of the effectiveness of treatment was carried out (after 2-4 weeks, then every 1-2 months), clinically and with bifunctional monitoring, correction of therapy. The observation period was 8 months. Results and discussion. By the end of the study, 27 patients had target blood pressure, significant decrease in systolic / diastolic blood pressure (10/5 mm Hg and more) occurred in 30 patients. A correlation was found between the effectiveness of antihypertensive treatment and the initial clinical and instrumental parameters of patients: age, heart size (including left ventricular hypertrophy - LVH), thyroid stimulating blood hormone (TSH) level and fasting blood glucose (within normal limits). The level of WARV also correlated with these indicators and was significantly higher in patients who achieved a significant reduction in blood pressure. No significant dynamics of WARV was detected. No relationship between baseline blood pressure with WARV and their changes were identified. The connection of the myocardial mass index with the level of TSH and glycated hemoglobin was demostrated. Conclusion. The WARV reflects the severity of organic heart changes associated with age, disease duration, metabolic profile, LVH - heart damage as a target organ in AH, but is not suitable for analyzing its functional changes within one stage of the disease.