Preview

"Arterial’naya Gipertenziya" ("Arterial Hypertension")

Advanced search

Resistant isolated systolic hypertension: prevalence, hemodynamic and clinical features

https://doi.org/10.18705/1607-419X-2012-18-6-497-504

Abstract

Objective. To investigate the prevalence, clinical features and markers of resistant isolated systolic hypertension (ISH) in elderly patients. Design and methods. 261 patients with essential arterial hypertension (AH) and mean age of 73,2 ± 7,2 were included into the study. Resistant AH was diagnosed both by the office BP and ABPM criteria. We detected and compared the ABPM parameters, myocardial, vessels and renal damage signs in the resistant ISH group with those of resistant systolic-diastolic hypertension (SDH) and controlled AH groups. Factors reliably associated with resistant ISH development were revealed by logistic regression. Results and conclusion. The resistant ISH was detected by office BP in 11,8 % and by ABPM in 12,2 % of elderly patients. The resistant SDH was diagnosed in 13,6 and 5,4 % respectively. The «white-coat» effect was found in 30,4 %. In patients with resistant ISH the systolic BP variability, Sokolow-Lyon voltage index, left ventricular ejection fraction decrease occurrence and ambulatory arterial stiffness index were greater than in the compared groups. In comparison to controlled AH the aortic pulse wave velocity was higher while ankle-brachial index was lower. We found the markers of resistant ISH to be systolic BP variability, aortic pulse wave velocity and ambulatory arterial stiffness index.

About the Authors

K. V. Protasov
Irkutsk State Medical Academy for Postgraduate Education
Russian Federation


O. V. Fedorishina
Irkutsk State Medical Academy for Postgraduate Education
Russian Federation


References

1. Резистентная артериальная гипертензия / под ред. Е.В. Шляхто. - СПб., 2012. - 118 с.

2. Lloyd-Jones D.M., Evans J.C., Larson M.G., O'Donnell C.J., Roccella E.J., Levy D. Differential control of systolic and diastolic blood pressure : factors associated with lack of blood pressure control in the community // Hypertension. - 2000. - Vol. 36, № 4. - P. 594-599.

3. Kannel W.B., Dawber T.R., McGee D.L. Perspectives on systolic hypertension. The Framingham study // Circulation. - 1980. - Vol. 61, № 6. - P. 1179-1182.

4. Резистентная артериальная гипертензия: диагностика, тактика и лечение. Научный доклад профессионального образовательного комитета при Совете по исследованиям в области повышенного артериального давления Американской Ассоциации Сердца / перевод А.О. Конради // Артериальная гипертензия. - 2008. – Т. 14, № 3. - С. 187-202.

5. Guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the ESH and ESC // J. Hypertens. - 2007. - Vol. 25, № 6. - P. 1105-1187.

6. Протасов К.В., Дзизинский А.А. Новый метод диагностики изолированной систолической артериальной гипертонии по данным суточного мониторирования артериального давления // Вестн. новых мед. технол. - 2008. – Т. 15, № 2. - С. 125-128.

7. Li Y., Wang J.G., Dolan E. et al. Ambulatory arterial stiffness index derived from 24-hour ambulatory blood pressure monitoring // Hypertension. - 2006. - Vol. 47, № 3. - P. 359-364.

8. de la Sierra A., Segura J., Banegas J.R. et al. Clinical features of 8295 patients with resistant hypertension classified on the basis of ambulatory blood pressure monitoring // Hypertension. - 2011. - Vol. 57, № 5. - P. 898-902.

9. Емельянов И.В., Авдонина Н.Г., Иваненко В.В. и др. Причины резистентности к терапии пациентов с неконтролируемой артериальной гипертензией: анализ работы специализированного центра // Артериальная гипертензия. - 2012. – Т. 18, № 2. - С. 96-101.

10. Massierer D., Oliveira A.C., Steinhorst A.M. et al. Prevalence of resistant hypertension in non-elderly adults: prospective study in a clinical setting // Arq. Bras. Cardiol. - 2012. – Vol. 99, № 1. – P. 630-635.

11. Brown M. J., Castaigne A., de Leeuw P.W. et al. Influence of diabetes and type of hypertension on response to antihypertensive treatment // Hypertension. - 2000. - Vol. 35, № 5. - P. 1038-1042.

12. Pickering T.G., Hall J.E., Appel L.J. et al. Recommendations of blood pressure measurement in humans and experimental animals. Part 1: blood pressure measurement in humans // Circulation. - 2005. - Vol. 111, № 5. - P. 697-716.

13. Martins L.C., Figueiredo V.N., Quinaglia T. et al. Characteristics of resistant hypertension: ageing, body mass index, hyperaldosteronism, cardiac hypertrophy and vascular stiffness // J. Hum. Hypertens. - 2011. - Vol. 25, № 9. - P. 532-538.

14. Чазова И.Е., Фомин В.В., Разуваева М.А., Вигдорчик А.В. Эпидемиологическая характеристика резистентной и неконтролируемой артериальной гипертензии в РФ (Российский регистр неконтролируемой и резистентной артериальной гипертензии РЕГАТА ПРИМА. Резистентная гипертония артериальная — причины и механизмы развития) // Системные гипертензии. - 2010. - № 3. - С. 34-41.

15. Pickering T.G. Arterial stiffness as a cause of resistant hypertension? // J. Clin. Hypertens. (Greenwich). - 2007. - Vol. 9, № 5. - P. 390-395.

16. Kario K. Obstructive sleep apnea syndrome and hypertension: ambulatory blood pressure // Hypertens. Res. - 2009. - Vol. 32, № 6. - P. 428-432.


Review

For citations:


Protasov K.V., Fedorishina O.V. Resistant isolated systolic hypertension: prevalence, hemodynamic and clinical features. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2012;18(6):497-504. (In Russ.) https://doi.org/10.18705/1607-419X-2012-18-6-497-504

Views: 1468


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1607-419X (Print)
ISSN 2411-8524 (Online)