Background. In the practice of clinical research, it is traditionally accepted to
evaluate parameters that characterize the degree of impairment or loss of the function
of an organ or system, and not their preservation. A fundamental change in the approach
distinguishes a new trend in modern medicine, which makes it possible to assess the
degree of preservation of functional resources, which was the basis of this study.Study
purpose: To develop a method for dynamic quantitative assessment of the severity of
arterial hypertension and evaluate the relationship between a qualitative indicator of
arterial hypertension and a quantitative indicator.Instruments and Data Collection
Procedure. Index of adaptive aptitude (IAA) (patent for invention No. 2342900 "Method
for eavaluation of the functional reserves of the body", author - Kurnikova I. A.).
using automated assessment (certificates of official registration No. 2007614560 and No.
2007613898).IAA=0.011(P-P*)+0.014(S-S*)+0.008(D-D*)+0.009(W-W*),Where: P - actual heart
rate (b/min.); P* - ideal pulse rate (beats/ min.); S - systolic blood pressure, actual
average per day (mm Hg); S* – ideal systolic blood pressure (mm Hg); D - diastolic blood
pressure, actual average per day (mm Hg); D* - ideal diastolic blood pressure (mm/Hg); W
- body weight at the time of examination (kg); W* - ideal body weight (kg); H -
patient's height at the time of examination (cm).Assessment of daily heart rate
variability on the Valenta system, equipped with a program for computer processing of
spectral analysis indicators.Results:- 143 patients with arterial hypertension (AH) were
examined. The relationship between a qualitative indicator - the severity of AH and
quantitative indicators - rehabilitation potential, the numerical value of which is PAS,
the circadian index (CI) as an indicator of increased sensitivity of the heart rate to
sympathetic stimulation, and the LF/HF vago sympathetic balance coefficient, which
increases with hypersympathatic tone, was considered. Statistical analysis of the
surface plot using the weighted least squares distance allowed this relationship to be
clearly demonstrated. Quantitative analogue of the Framingham arterial hypertension
severity scale (AHSS) in a specific patient (certificate for invention №. 201152181)AHSS
= 119,31 + 2,22× (CI) - 2,03× (IAA) - 1,33×(2×(CI)) + 2,72×(CI)× (IAA) +
7,06×(IAA)where: AHSS less than 120 - normal. Mild AHSS = 121 – 130 points; average
severity of AHSS = 131 – 140 points; severe AHSS - 141 points or more. The effectiveness
of rehabilitation is good with AHSS less than 120, satisfactory - with 121 - 130;
unsatisfactory - more than 131.For illustration, the data of 54 patients are presented.
Observation group "1" - patients with AH (BMI<25), mean age - 49±1.9 years (19
people). Observation group "2" - patients with metabolic syndrome (BMI>25; HOMA
index> 2.5), mean age - 50±1.7 (35 people). All patients were assessed for the
severity of hypertension according to the WHO criteria and the AHSS index at the
beginning of the study. Normal value was achieved in 41.8% in 1st group during
treatment, in 47.1% there was a decrease in the severity of AH according to AHSS. In
group 2, in patients with metabolic syndrome during treatment, it was possible to
normalize blood pressure in 55.8%, and to obtain satisfactory results in
35.9%.Conclusion. Developed mathematical modeling methods, a quantitative analogue
indicator of the severity of arterial hypertension - AHSS allows you to dynamically
monitor the effectiveness of treatment and evaluate the achieved result based on a
quantitative assessment within the severity indicated by the classification. The
effectiveness of the rehabilitation of patients with hypertension is considered
sufficient if the AHSS decreases below the value of 120 units or one level from the
baseline
