The parameters of the daily blood pressure profile in hypertensive patients depending on the presence of chronic heart failure and senile asthenia syndrome

Objective. The aim of the study was to identify the features of the daily blood pressure (BP) profile in patients with arterial hypertension (HTN), depending on the presence of chronic heart failure (CHF) and senile asthenia syndrome (SAS). Design and methods. In total, 320 respondents with HTN (56,9 % of women and 43,1 % of men, average age 85,8 ± 4,5 years) were divided into four groups: group 1A — patients with HTN, SAS and CHF (n = 84), group 1B — patients with HTN, CSA without CHF (n = 77), group 2A —patients with HTN, CHF without SAS (n = 84), group 2B — patients with HTN without CHF and without SAS (n = 75). The Age is not a Hindrance questionnaire was used to diagnose SAS and a comprehensive geriatric assessment was performed. All patients underwent ambulatory blood pressure monitoring (ABPM) and the following parameters of blood pressure (BP) were assessed: the average daily, night, daytime indicators of systolic blood pressure (SBP), diastolic blood pressure (DBP) and pulse blood pressure (PBP), as well as their variability, the degree of nocturnal BP decrease and BP load indices. Results. In patients with HTN without SAS, the presence of CHF led to significantly lower values of SBP and DBP at all time intervals (p < 0,005), lower values of the SBP time index(s) per day (p = 0.,07) and night (p < 0,001), as well as the SBP area index (S) (p < 0,001), a significantly higher percentage of “dipper” cases by SBP (p < 0,001), a lower percentage of “non-dippers” (p < 0,001) and “night-peakers” by SBP (p = 0,046) compared with HTN patients without SAS and CHF. In the presence of SAS, patients with HTN without CHF, compared with HTN patients without SAS and CHF, also had lower values of SBP and DBP at all time intervals (p < 0,005), BP load indicators (and SBP per day (p < 0,001) and night (p < 0,001), SBP load index (p < 0,001)). In addition, higher SBP variability was observed during the day (p = 0,001) and at night (p < 0,001). The following features are typical for patients with HTN and SAS: a significant increase in the percentage of “dippers” by SBP (p = 0,004), a decrease in the percentage of “non-dippers” (p = 0,002), and a greater percentage of patients with excessive decrease in SBP at night (“over-dipper”) (p = 0,038). Conclusions. Our study provided information about ABPM parameters in hypertensive elderly patients aged 80 years and older with CHF only, SAS only and with coexisting CHF and SAS.

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