FEATURES OF CENTRAL HEMODYNAMICS IN YOUNG PEOPLE WITH SYSTOLO-DIASTOLIC HYPERTENSION
Abstract
Objective. To study the features of central hemodynamics in young people with systolic-diastolic arterial hypertension. Methods. Applanation tonometry (SphygmoCor device) was
used to study blood pressure (BP) levels and features of the central and peripheral pulse waves in 105 young people with increased SBP. The control group consisted of 90 young people with normal blood pressure levels. Results. In young people aged 17–29 years, systolic-diastolic AH was determined as a result of an increase in the stroke volume of the heart and central pulse pressure (PAP), and due to the damping function of the aorta, which influenced the increase in DBP. In patients with hypertension, an increase in the maximum rate of rise of the peripheral pulse wave (PmaxdP/dt), which reflects the magnitude of the stroke volume of the heart, was the main factor in increasing PBP not only in ISAH, but also in patients with SDAH, and due to the damping function of the aorta, it influenced and on the value of DBP. Peripheral SBP did not differ in ISAH and SDAH, while central SBP was higher in SDAH. In patients with ADHD, a higher heart rate contributes to an increase in DBP. An increase in the augmentation of the central pulse wave contributes to an increase in the central DBP. The ugmentation waves additionally increase the central diastolic blood pressure throughout the diastole, while the area index of the diastolic part of the pulse wave is significantly increased. This suggests that throughout the diastole there is an increase in the amplitude of the pulse wave. In SDAH, due to the high level of the constant component of pressure in the aorta, the indicators that characterize the propulsive capacity of the cardiovascular system are increased. This happens in order to improve the blood supply to the central organs. The increase in DBP in the initial part of diastole was of significance. With SDAH, the load on the myocardium was also increased. This led to the fact that the Bückberg subendocardial viability ratio (C_SVI) was reduced in them compared to ISAH patients. The median degree of pulse wave amplification on the arm in SDAH patients was 176%, which leads to an increase in pulse pressure and SBP on the arm. According to the generally accepted classification of hypertension, in which the minimum level of SBP on the arm is 140 mm Hg. Art., the level of SBP in the aorta should be lower by the value of the degree of amplification, so the minimum level of elevated SBP in the aorta in patients with DSBP in the aorta should be considered 120 mm Hg. Art. In patients with SDAH, in whom the level of SBP in the aorta was within the normal range, it indicates a “false” hypertension, in those whose level of SBP in the aorta was above 120 mm Hg, about true hypertension. Conclusion. The study showed that at a young age in young people aged 17–29 years, an increase in stroke volume and high amplification of the pulse wave are the leading factor in increasing PAP not only in isolated systolic AH, but also had an effect on increasing PAP, but due to dempfiring function of the aorta and an increase in DBP in systolicdiastolic hypertension. With ISAH and SDAH at a young age, the central SBP may be less than 120 mm Hg. Art. In this case, “false” hypertension is diagnosed, in which no restrictions are required in the choice of profession and drug therapy. Our studies indicate that at a young age (from 17 to 29 years old), the normal level of central systolic pressure is pressure up to 120 mm Hg. Art.
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