SOME FEATURES OF ARTERIAL AND VENOUS HEMODYNAMICS IN PATIENTS WITH ESSENTIAL HYPERTENTION STAGE II WITH DIFFERENT VARIANTS OF THE BLOOD PRESSURE DAILY STRUCTURE

Abstract

Aim - establish features of arterial and venous hemodynamics in patients with the 2ndstage of essential hypertension (EH) with various options of circadian structure of theblood pressure (BP).Material and methods. There were examined 52 patients with the 2nd stage of essentialhypertension (EH) with the average age of 54,8±2,12. All patients underwent daily BPmonitoring (DBPM) with the help of the hardware complex "Solvaig" (Ukraine) andangiotensiotonoreobarography according to the author's method that determined thevalues of the pressures of closing and opening the arteries and veins of the limb underthe medical cuff (as for checking BP).Results. According to the data of DBPM in “non-dippers” patients the average dailypulse blood pressure (APBP) was significantly higher in the night picker (NP), and theaverage dynamic blood pressure increased mainly during the night period.The values of the daily index in these groups “non-dippers” (ND) and NP are mainlycaused by the daily dynamics of the diastolic BP.There were detected 17(80.8%) patients of the ND group and 12 (92.3%) patients withNP rhythm that had a high level of venous closure pressure. Venous hypertension wasconfirmed according to the data of CVP by the classical method of Waldman.The proposed method of examination of patients with the 2nd stage of essentialhypertension makes it possible to detect arteriovenous hypertension and to determineit as a significant risk factor for the progression of EH and resistant to treatment form,pathogenetically justify complex AH-therapy using optimal doses of diuretics.Conclusion. Circadian variant - ND and NP "not dippers" has been revealed in mostpatients with the 2nd stage of EH (65.4%). Combined arteriovenous hypertension(AVH) was detected in 87% of thematic patients with daily ND and NP structure. Thediagnosed AVH in patients with the 2nd stage of EH is an additional risk factor for EHand requires a pathogenetically sound approach to AH-treatment with mandatory useof diuretics in optimal doses.