Peculiarities of the daily profile of arterial pressure and vascular stiffness in arterial hypertension and chronic heart failure patients with senile asthenia syndrome
Abstract. Cardiovascular diseases have a direct dependence with vascular stiffness and indexes of the daily profile of blood pressure (BP), increasing cardiovascular risk, especially in elderly patients with senile asthenia syndrome (SAS).Safronenko V.A., Chesnikova A.I.
The aim: to identify peculiarities of the daily profile of BP and vascular stiffness in patients with arterial hypertension (AH) and chronic heart failure (CHF) depending on the presence of SAS.
Material and methods. 161 respondents with AH and CHF (82 females and 79 males) aged 80 to 91 years were involved in the study. Taking into account the presence of SAS, they were divided into 2 groups: 1st – patients with AH, CHF and SAS (n = 84), 2nd – patients with AH and CHF without SAS (n = 77). To diagnose SAS, questionnaire “Age is not a hindrance” was used and a comprehensive geriatric assessment was carried out. All patients underwent 24-hour BP monitoring with determination of the indexes of the daily BP profile, vascular stiffness and central aortic pressure.
Results. In patients with arterial hypertension, CHF and SAS presence, comparatively to patients without SAS, statistically significantly lower values of systolic BP (SBP) at night (p = 0.026) and diastolic BP during the day and night (p < 0.001 and p < 0.001, respectively), higher values of variability of SBP (p = 0.004 and p < 0.001, respectively) and pulse BP (PBP; p < 0.001 and p = 0.029, respectively) during the day and night were observed, as well as a significantly higher percentage of the daily index of SBP by the night-peaker type (p = 0.048). Analysis of vascular stiffness revealed significantly lower RWTT values (p < 0.001) and higher PWVao (p = 0.001), ASI (p < 0.001) and AASI (p = 0.002) in comorbid patients with SAS, which indicates increased vascular stiffness in this group of patients. When assessing central aortic pressure in patients with SAS comparatively to patients without this syndrome, statistically significantly lower SADao values (p = 0.004) and higher PADao and AIxao levels (p = 0.027 and p < 0.001, respectively) were revealed.
Conclusion. In patients with AH and CHF aged ≥ 80 years, the development of SAS was accompanied by more pronounced changes in the parameters of the daily BP profile, as well as the elastic characteristics of blood vessels, which suggests a higher risk of cardiovascular complications in case of this combined pathology.
Keywords
arterial hypertension
chronic heart failure
frailty syndrome
daily blood pressure profile
vascular rigidity
central aortic pressure
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About the Authors
Victoria A. Safronenko, MD, PhD (Medicine), associate professor of the Department of internal medicine No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.E-mail: v.chugunova@mail.ru
ORCID: https://orcid.org/0000-0002-6965-5019. Scopus ID: 56429549100. eLibrary SPIN: 1073-6548
Anna I. Chesnikova, MD, Dr. Sci. (Medicine), professor, head of the Department of internal medicine No. 1, Rostov state medical university of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane.
E-mail: rostov-ossn@yandex.ru
ORCID: https://orcid.org/0000-0002-9323-592X. Scopus ID: 55344352600. eLibrary SPIN: 9677-0932
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