Актуальні Аспекти Варіабельності  Артеріального Тиску При Артеріальній Гіпертензії

Boev, S.S.; Dotsenko, N. Ya.; Герасименко, Л В; Shekhunova, I.A.

doi:10.22141/2224-1485.2.58.2018.131065

2021

DOI: 10.22141/2224-1485.2.58.2018.131065

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Актуальні Аспекти Варіабельності Артеріального Тиску При Артеріальній Гіпертензії

S.S. Boev

N. Ya. Dotsenko

Л В Герасименко

et al.

Abstract: Актуальні аспекти варіабельності артеріального тиску при артеріальній гіпертензії Резюме. Ця стаття є оглядом даних літератури про клінічне значення варіабельності артеріального тиску в пацієнтів з артеріальною гіпертензією. Наведено найбільш часто аналізовані показники варіабельності артеріального тиску, особливості класифікації. Подані результати досліджень, присвячених взаємозв'язку показників варіабельності артеріального тиску та стратифікації серцево-судинних ризиків. Наводиться огляд даних про особливост… Show more

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Cited by 4 publications

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Hypertensive retinopathy: clinical aspects

Dotsenko

Shekhunova

Boev

et al. 2022

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Funduscopic examination has long been recognized as the most affordable way to assess the condition of small diameter vessels. However, accumulation of new research data, changes in the requirements for the management of patients with various diseases require a return to the clinical, prognostic significance of fundoscopy and the specification of indications for its conduction in certain situations. This article discusses the prevalence of retinopathy depending on the etiological factor, criteria and stages of its development. Until now, a number of issues regarding retinopathy have not been finally resolved, in particular the classification optimal for routine practice, method of its study, etc. It is believed that changes in the fundus blood vessels reflect parallel changes in the vessels of other regions, but this is not always so. A moderate prognostic value of “mild” retinopathy has been established in terms of the risk of cardiovascular diseases, with moderate retinopathy, this relationship reaches a strong level, and with a malignant one, there is a strong correlation with death. The article discusses indications for fundoscopy in routine clinical practice, taking into account the latest scientific data and international recommendations. For the treatment of hypertensive retinopathy, only adequate control of blood pressure is recommended, which can reduce the signs of retinopathy. The authors concluded that the prognostic value of stage 1–2 hypertensive retinopathy is minimal and does not affect patient management. The latter eliminates the need for fundoscopy in patients with mild, controlled arterial hypertension, not suffering from diabetes, with the exception of young patients. Fundoscopy is required in patients with difficult-to-control and resistant arterial hypertension, high variability of blood pressure.

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Hypertensive retinopathy: clinical aspects

Dotsenko

Shekhunova

Boev

et al. 2022

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Technical, Clinical and Prognostic Aspects of Hypertensive Retinopathy

Dotsenko¹,

Boev²,

Нerasymenko³

et al. 2020

Journal GrSMU

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Changing approaches to the management of patients with arterial hypertension, reflected in international recommendations regarding, including diagnosis, determination of a cardiovascular risk, required to return to the issue of the place of fundoscopy in routine clinical practice. Recent studies have clarified the prevalence of various retinopathy options using new, highly accurate instruments. A large number of works are devoted to the study of the prognostic role of fundoscopy, and here the opinions of researchers are unequivocal: the detection of signs of the initial stages of retinopathy has a very little effect on patient management. It should be agreed with the opinion of experts from the European Cardiology Society that fundoscopy is indicated mainly in patients with difficult to control or resistant hypertension, and is not recommended for people with mild to moderate hypertension, not suffering from diabetes, with the exception of young patients.

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Visit-to-Visit Blood Pressure Variability in Rural Males With Arterial Hypertension: Association With Non-Valvular Atrial Fibrillation

Nimtsovych¹,

Kravchenko²,

Mishcheniuk³

et al. 2020

Clin. and prev. med.

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Purpose: to study the association of blood pressure (BP) visit-to-visit variability (VVV) with non-valvular atrial fibrillation (AF) in rural dwellers with arterial hypertension (HTN). Material and methods. The cross-sectional study retrospectively analyzed complex data from consecutive 160 males with primary HTN (mean age 50 ± 6 years). Patients with major HTN complication were excluded. We analyzed the office systolic BP (SBP) and diastolic BP (DBP) levels, obtained at four consecutive doctor`s visits. As a metric of BP VVV, we used standard deviation (SD) and coefficient of variation (CV) values. The criteria for high BP VVV were Patients were ascertained to have high BP VVV in case of SD (SBP) ≥15 mm Hg and/or SD (DBP) ≥14 mm Hg. Totally, high BP VVV status was in 82 (51,3 %) patients. Paroxysmal AF was detected in 29 (18,1 %) patients. Results. HTN with AF group (vs. HTN alone) was characterized by higher average values of BB VVV metrics (median, interquartile range): SD (SBP) (16,7 (15,9-17,5) vs. 8,7 (4,6-15,2) mm Hg, respectively); SD (DBP) (11,5 (8,9-14,6) vs. 5,7 (3,9-8,9) mm Hg, respectively); CV (SBP) (10,1 (9,6-10,7) vs. 5,6 (2,9-9,2) %, respectively); and CV (DBP) (12,9 (9,3-15,5) vs. 6,3 (4,1-9,7) %, respectively) (р<0,001 in all the comparisons). Additionally, HTN with AF group associated with worse kidney filtration function (estimated glomerular filtration rate (eGFR): 57 (53-59) vs. 67 (62-77) ml/mim/1,73 m2, respectively) and more pronounced albuminuria (urine albumin/creatinine ratio (A/Cu): 36,1 (32,3-40,6) vs. 10,3 (6,5-26,9) mg/mmol, respectively) (р<0,001 in both comparisons). While integral assessment of eGFR and A/Cu values, we determined higher frequency of patients with high and very high cardiovascular and renal adverse events risk (AER) in HTN with AF group. Moreover, patients with HTN and AF presented with higher left atrial antero-posterior dimension (LAD) (4,3 (4,2-4,6) сm vs. 3,9 (3,6-4,1) cm, respectively; р<0,001), as well as with more advanced left ventricular remodeling. At multivariable analysis, SD (SBP) ≥15 mm Hg and SD (DBP) ≥14 mm Hg, along with AER and LAD, were the most significant factors independently associated with AF. Conclusion. In rural males with HTN, the presence of high BP VVV is one of the factors associated with non-valvular AF risk increase. High BP VVV could be proposed as an additional modified AF risk factor in patients with HTN.

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Актуальні Аспекти Варіабельності Артеріального Тиску При Артеріальній Гіпертензії

Cited by 4 publications

References 51 publications

Hypertensive retinopathy: clinical aspects

Hypertensive retinopathy: clinical aspects

Technical, Clinical and Prognostic Aspects of Hypertensive Retinopathy

Visit-to-Visit Blood Pressure Variability in Rural Males With Arterial Hypertension: Association With Non-Valvular Atrial Fibrillation

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