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Клиническое значение давления, измеренного различными способами, у пациентов с артериальной гипертензией

Клиническое значение давления, измеренного различными способами, у пациентов с артериальной гипертензией

Abstract

Цель. Оценить наличие и степень взаимосвязи центрального, офисного и суточного артериального давления (АД) с показателями поражения органов-мишеней. Материалы и методы. Обследовано 62 пациента с эссенциальной артериальной гипертензией (АГ) разной степени в возрасте 49,6 ± 2,1 года. Результаты. Центральные систолическое (САД) и пульсовое (ПАД) АД (в отличие от офисных и среднесуточных) достоверно коррелировали со всеми показателями, кроме тех, которые характеризуют поражения почек и лодыжечно-плечевой индекс. Сильнее взаимосвязь была со скоростью распространения пульсовой волны эластического (СРПВэ) (r = 0,57, p < 0,001) и мышечного типа (СРПВм) (r = 0,45, p < 0,001). СРПВэ независимо коррелировала только с офисным диастолическим АД (β = 4,3, Р = 0,042), центральными САД (β = 6,6, Р = 0,05) и ПАД (β = 4,5, Р = 0,03), а СРПВм только с центральным САД (β = 0,50, Р < 0,001). С толщиной комплекса интима-медиа было связано центральное ПАД (β = 0,40, Р = 0,011; β = 0,34, Р = 0,025). Нарушение диастолической функции (Е/Е′) достоверно связано только с центральным САД (β = 0,55, Р = 0,039). Вывод. Уровень АД в аорте влияет на поражение органов-мишеней, особенно сосудов, что проявлялось нарушениями их упруго-эластичных свойств или утолщением комплекса интима-медиа.

Objective. To evaluate the presence and degree of correlation of central, office and daily blood pressure (BP) with the indicators of target organ damage. Materials and Methods. The study involved 62 patients with essential hypertension of various degrees, aged 49.6 ± 2.1 years. Results. Central systolic BP (SBP) and pulse pressure (PP) (unlike the office and daily average ones) significantly correlated with all indicators, except those which characterize the renal lesion and ancle-brachial index. The strongest relationship was with pulse wave velocity in elastic (PWVe) (r = 0.57, p < 0.001) and muscular arteries (PWVm) (r = 0.45, P < 0.001). PWVe independently correlated only with office diastolic BP (β = 4.3, P = 0.042), central SBP (β = 6.6, P = 0.05) and PP (β = 4.5, P = 0.03) and PWVm only with central PP (β = 0.50, P < 0.001). Central PP (β = 0.40, P = 0.011; and β = 0.34, P = 0.025) was associated with intima-media thickness. Diastolic dysfunction (Е/Е′) was significantly associated only with central SBP (β = 0.55, P = 0.039). Conclusion. BP level in the aorta has an influence on the formation of target organ damage, particularly on vessels that manifested by violations of their elastic properties, or thickening of the intima-media.

Keywords

АРТЕРіАЛЬНА ГіПЕРТЕНЗіЯ,ЦЕНТРАЛЬНИЙ АРТЕРіАЛЬНИЙ ТИСК,CENTRAL BLOOD PRESSURE,ОРГАНИ-МіШЕНі,АРТЕРИАЛЬНАЯ ГИПЕРТЕНЗИЯ,HYPERTENSION,ЦЕНТРАЛЬНОЕ АРТЕРИАЛЬНОЕ ДАВЛЕНИЕ,ОРГАНЫ-МИШЕНИ,TARGET ORGANS

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
0
Average
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