Chronostructure of blood pressure in shift-workers in the Arctic polar region
https://doi.org/10.18705/1607-419X-2015-21-5-500-513
Abstract
Objective. To study clinical differences of arterial hypertension (HTN), to conduct both standard comparative analysis of 24‑hour blood pressure (BP) monitoring and cosinor-analysis for chronobiological assessment of HTN circadian rhythms in shift workers of the Arctic polar region and native residents of Tyumen city.
Design and methods. Altogether 373 patients with HTN stage I–II (control group) and 144 patients with HTN stage I–II (comparative group) were examined and underwent 24‑hour BP monitoring, echocardiography, brachiocephalic artery ultrasound, treadmill ergometer test, 24‑hour ECG Holter monitoring.
Results. In the conditions of Arctic shift work, clinical implications of HTN were more evident and associated with structural heart alterations, high frequency of atherosclerosisin brachiocephalic arteries, dyslipidemia, low exercise tolerance and level of adaptive potential. In northern citizens with HTN circadian BP profile was associated with low circadian rhythm indices, high BP variability, mainly night hyperbaric overload that explains high frequency of HTN circadian BP profile («non-dipper» and «night-peaker»). Chronobiological disturbances in HTN circadian rhythm in shift workers was caused by the malfunction of correspondence in internal and external cueing of physiological processes (desynchronosis) influenced by the conditions of shiftwork.
About the Authors
N. P. Shurkevich
“Tyumen Cardiology Center” Branch of Federal State Budgetary Research Institution «Research Institute of Cardiology»
Russian Federation
Russian Federation
MD, PhD, DSc, Senior Researcher, Department of Arterial Hypertension and Coronary Insufficiency, Scientific Department of Clinical Cardiology,
111 Melnikaite street, Tyumen, 625026
A. S. Vetoshkin
Medical Unit “Gazprom dobycha Yamburg” LLC
Russian Federation
Russian Federation
MD, PhD, DSc, Functional and Ultrasound Diagnostics Department,
Yamburg
L. I. Gapon
“Tyumen Cardiology Center” Branch of Federal State Budgetary Research Institution «Research Institute of Cardiology»
Russian Federation
Russian Federation
MD, PhD, DSc, Professor, Honored Scientist of the Russian Federation, Head, Scientific Department of Clinical Cardiology,
111 Melnikaite street, Tyumen, 625026
N. V. Shipitsyna
“Tyumen Cardiology Center” Branch of Federal State Budgetary Research Institution «Research Institute of Cardiology»
Russian Federation
Russian Federation
MD, PhD, Cardiologist, Department of Arterial Hypertension and Coronary Insufficiency, Scientific Department of Clinical Cardiology,
111 Melnikaite street, Tyumen, 625026
D. G. Gubin
Tyumen State Medical Academy
Russian Federation
Russian Federation
MD, PhD, DSc, Professor, Head, Biology Department,
Tyumen
F. A. Poshinov
Medical Unit “Gazprom dobycha Yamburg” LLC
Russian Federation
Russian Federation
MD, PhD, Cardiologist of the highest level of specialization,
Yamburg
References
1. Ощепкова Е.В. Федеральная программа «Профилактика и лечение артериальной гипертонии в РФ» 5‑летние итоги ее реализации. Здравоохранение РФ. 2007;5:18–21. [Oshchepkova EV. Prevention and treatment of an arterial hypertension in the Russian Federation 5-year results of its realization. Zdravookhranenie RF = Health Care System in Russia. 2007;5:18–21. In Russian].
2. Буганов А. А., Ивлева Г. И., Тесля Е. Ф. Структурно-функциональные изменения миокарда у больных артериальной гипертонией. ассоциированной с патологией щитовидной железы на Крайнем Севере. Вестник РАМН. 2008;5:32–35. [Buganov AA, Ivleva GI, Teslya EF. Structural and functional changes of the myocardium in patients with arterial hypertension associated with thyroid pathology in Far North. Vestnik RAMN = Bulleten of RAMS. 2008;5:32–35. In Russian].
3. Архиповский В. Л. Сердечно-сосудистая патология: распространенность. основные факторы риска. Экология человека. 2007;7:20–25. [Arkhipovskiy VL. Cardiovascular pathology: prevalence. major risk factors. Ekologiya Cheloveka = Human Ecology. 2007;7:20–25. In Russian].
4. Кривощеков С. Г., Леутин В. П., Диверт В. Э., Диверт Г.М., Платонов Я.Г., Ковтун Л.Т. и др. Системные механизмы адаптации и компенсации. Бюлл. СО РАМН. 2004; (112),2:149–153. [Krivoschekov SG, Leutin VP, Divert VE, Divert GM, Platonov YaG, Kovtun LT et al. System mechanisms of adaptation and compensation. Bulleten of Siberian Branch of RAMS. 2004;112(2):149–153. In Russian].
5. Попушой А.А., Налимов М.Ю., Четвертаков В.А., Малишевский М.В., Клевцова Т.В., Васина А.А. и др. К вопросу об артериальной гипертензии у коренного населения Крайнего Севера. Мед. наука и образование Урала. 2012;13(1):111–112. [Popushoy AA, Nalimov MYu, Chetvertakov VA, Malishevskiy MV, Klevtscova TV, Vasina AA et al. To a question of arterial hypertension at indigenous people of Far North. Meditsinskaya Nauka i Obrazovanie Urala = Medical Science and Education in Ural. 2012;13(1):111–112. In Russian].
6. Боровиков В. А. Вахтовый метод организации труда: актуальность институционализации социально-трудовых отношений. Труд и социальные отношения. 2008;4:96–100. [Borovikov VA. Shift method of the organization of work: relevance of an institutionalization of the social and labor relations. Trud i Sotsialnye Otnosheniya = Work and Social Relations. 2008;4:96–100. In Russian].
7. Кривощеков А. П. Комплексное социально-гигиеническое исследование по охране здоровья работающих в газодобывающей промышленности в условиях Крайнего Севера Западной Сибири. Крайний Север: особенности труда и социализации человека: материалы междунар. науч.-практ. конф.. Нов. Уренгой. 4–6 дек. 2008;2010:120–122. [Krivoschekov AP. Complex social and hygienic research on health protection working in the gasindustry in Far North of Western Siberia. Abstract book of the International Scientific and Practical Conference. Nov. Urengoj. 2008;2010:120–122. In Russian].
8. Агаджанян Н. А. Губин Г. Д., Губин Д. Г. Хроноархитектоника биоритмов и среда обитания. Тюмень: Изд-во Тюменского ун-та. 1998: 168 с. [Agadzhanyan NA, Gubin GD, Gubin DG. Chronostructure of biological rhythms and habitat. Tyumen: Publishing House of Tyumen State University. 1998: 168 р. In Russian].
9. Hermida RC, Ayala DT, Calvo C, Portaluppi F, Smolensky MH. Chronotherapy of hypertension: administration-timedependent effects of treatment on the circadian pattern of blood pressure. Advanced Drug Delivery Reviews. 2007;(59):923–939.
10. Хетагурова Л. Г., Салбиев К. Д. Хронопатофизиология доклинических нарушений здоровья. Владикавказ: Проект-Экспресс. 2000: 175 с. [Khetagurova LG, Salbiev KD. Chronometrically preclinical health disorders. Vladikavkaz: ProektJekspress. 2000: 175 р. In Russian].
11. Рагозин О.Н., Бочкарев М.В. Ультрадианный вариант течения артериальной гипертензии на Севере в условиях измененного фотопериодизма. Материалы XII Международного симпозиума «Эколого-физиологические проблемы адаптации». Москва: РУДН. 2007:353–354. [Ragozin ON, Bochkarev MV. Ultratiny variant of arterial hypertension in the North in modified absence. Abstract book of the XII International Symposium “Ecological and physiological problems of adaptation”. Moscow: RUDN. 2007:353–354. In Russian].
12. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P. Bornstein et al. Mannheim carotid intima-media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd. 4th and 5th watching the risk symposia. at the 13th. 15th and 20th European Stroke Conferences. Mannheim. Germany. 2004. Brussels. Belgium. 2006. and Hamburg. Germany. 2011. Cerebrovasc Dis. 2012;34(4):290–6. doi: 10.1159/000343145.
13. Баевский Р.М., Береснева А.П., Палеев Р.Н. Оценка адаптационного потенциала системы кровообращения при массовых профилактических обследованиях населения. Экспресс-информация ВНИИМИ.М.. 1987. 65 с. [Baevsky RM, Berseneva AP, Palev RN rank adaptive capacity of the circulatory system during mass preventive examinations of the population. Express information VNIIMI.M.. 1987. 65 p. In Russian]
14. Вейн А. М. Вегетативные расстройства. Клиника. Диагностика. Лечение. М.: Медицинское информационное агентство. 2003: 749 с. [Veyn AM. Vegetative frustration. Clinic. Diagnostics. Treatment. Moscow: Medical Information Agency. 2003: p. 749. In Russian].
15. Hltaky MA, Boineau RE, Higginbotham MB, Lee KL, Mark DB, Califf RM et al. A brief self-administered questionnaire to determine functional capacity (The Duke Activity Status Index). Am J Cardio. 1989; Sep 15. 64(10):651–4: 651–654.
16. Nelson W., Tong YL, Lee JK, Halberg F. Methods for cosinor-rhythmometry. Chronobiologia. 1979; Oct-Dec; 6(4):305–23.
17. Zuther P, Witte K. Lemmer B ABPM-FIT and CV-SORT: an easy-to-use software package for detailed analysis of data from ambulatory blood pressure monitoring. Blood Press Monit. 1996; Aug;1(4):347–354.
18. Halberg F, Scheving LE, Lucas E. Cornélissen G, Sothern RB, Halberg E et al. Chronobiology of human blood pressure in the light of static (room-restricted) automatic monitoring. Chronobiologia. 1984; Jul-Sep;11(3):217–47.
19. Тихонов П. П., Соколова Л. А. Особенности регуляторных механизмов автономной нервной системы у больных артериальной гипертензией с нарушением суточного профиля артериального давления. Кардиология. 2007;47(1):16–22. [Tikhonov PP, Sokolova LA. Features of regulatory mechanisms of autonomous nervous system at patients with arterial hypertension with violation of a daily profile of arterial pressure. Kardiologiia. 2007;47(1):16–22. In Russian].
20. Ердакова Т.К., Саламатина Л.В., Буганов А.А. Структурно-функциональные изменения сосудистой стенки у больных артериальной гипертонией на Крайнем Севере. Российский мед.-биол. вестник им. И. П. Павлова. 2009;2:89–93. [YerdakovaTK, Salamatina LV, Buganov AA. Structurally functional changes of a vascular wall at patients with an arterial hypertension on Far North. Rossijskij Mediko-biologicheskiy Vestnik im. I.P. Pavlova = Russian Medical and Biology Bulleten n.a.I.P. Pavlov. 2009;2:89–93. In Russian].
21. Белоусов Ю.Б., Несмараев Ж.Н. Эндотелиальная дисфункция как причина атеросклеротического поражения артерий при артериальной гипертензии. Фарматека. 2004;84(6):62–72. [Belousov YuB, Nesmaraev ZhN. Endotelial dysfunction as the reason of atherosclerotic damage of arteries at arterial hypertension. Farmateka. 2004;84(6):62–72. In Russian].
22. Агаджанян Н.А., Саламатина Л.В., Буганов А.А. Органные поражения и хронобиологическая структура суточного ритма артериального давления обследованных на Крайнем Севере. Вестн. Российского университета дружбы народов. Серия Медицина. 2003;2:23–29. [Agadzhanyan NA, Salamatina LV, Buganov AA. Organ defeats and hronobiologichesky structure of a daily rhythm of arterial pressure surveyed on Far North. Vestnik Rossijskogo Universiteta Druzhby Narodov = Bulleten of Russian University of People’s Friendship. Medicine. 2003;2:23–29. In Russian].
23. Провоторов В.М., Лышова О.В., Чернов Ю.Н. Особенности суточной вариабельности артериального давления и сердечного ритма у больных гипертонической болезнью. Вестник аритмологии. 2000;20:66–72. [Provotorov VM, Lyshova OV, Chernov YuN. Features of daily variability of arterial pressure and warm rhythm at patients with a hypertensive illness. Vestnik Aritmologii = Bulleten of Arrhythmology. 2000;20:66–72. In Russian].
24. Поляков В.Я., Николаев Ю.А., Мациевская Т.Р. Региональные особенности суточного профиля артериального давления у больных артериальной гипертензией и их взаимосвязь с факторами риска сердечно-сосудистых заболеваний. Бюлл. СО РАМН. 2011;(31)6:93–98. [Polyakov VYa., Nikolaev YU., Matsievskaya TR. Regional features of a daily profile of arterial pressure at patients with arterial hypertension and their interrelation with risk factors of cardiovascular diseases. Bulleten of Siberian Branch of RAMS. 2011; (31)6:93–98. In Russian].
25. Иевлева Г.И., Саламатина Л.В., Буганов А.А., Федорова Ю.А. Оценка артериального давления у трудоспособного населения Крайнего Севера. Медицина труда и пром. экология. 2003;2:11–13. [Ievleva GI, Salamatina IV, Buganov AA, Fedorova YuA. An assessment of arterial pressure at able-bodied population of Far North. Medicina Truda i Promyshlennaya Ekologiya = Professional Medicine and Industrial Ecology. 2003;2:11–13. In Russian].
26. Бpeyc T. К., Чибисов C. M., Баевский Р. М., Шебзухов K.B. Хроноструктура биоритмов сердца и факторы внешней среды.М.: Изд-во Росс. ун-та дружбы народов. 2002: р. 232. ISBN 5–209–01404–5. [Breus TK, Chibisov CM, Baevskij RM, Shebzukhov KV. Chronostrukture of biorhythms of heart and environment factors. Moscow: Publishing House of the Russian University of People’s Friendship. 2002: 232 с. ISBN 5–209–01404–5. In Russian].
Review
For citations:
Shurkevich N.P., Vetoshkin A.S., Gapon L.I., Shipitsyna N.V., Gubin D.G., Poshinov F.A. Chronostructure of blood pressure in shift-workers in the Arctic polar region. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2015;21(5):500-513. (In Russ.) https://doi.org/10.18705/1607-419X-2015-21-5-500-513
Views:
1107
Email this article 