24-hour systolic wave increment index monitoring in patients with low-renin arterial hypertension


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Abstract

AIM. To analyze the circadian rhythm of blood pressure (BP) and daily reflected wave values in patients with low-renin hypertension with normal and elevated aldosterone production. MATERIALS AND METHODS. The investigation included 66 patients. 24-hour BP monitoring was carried out and arterial wall rigidity and reflected wave values were assessed in all the patients. RESULTS. The patients with hyperaldosteronemia were found to have not only statistically significant severer hypertension, impaired circadian rhythms of BP, but also impaired augmentation index (Aix) - mainly its nocturnal increase. A positive correlation was found between nocturnal Aix and resting plasma aldosterone concentrations (r=-0.31; р=0.002). CONCLUSION. The findings suggest the expediency of 24-hour systolic wave increment index monitoring in hypertensive patients of this category.

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Суточное мониторирование индекса прироста систолической волны у больных с низкорениновыми формами артериальной гипертонии. - Резюме. Цель исследования. Анализ суточного ритма артериального давления (АД) и суточных показателей отраженной волны у больных с низкорениновыми формами артериальной гипертонии (АГ) при нормальной и повышенной продукции альдостерона. Материалы и методы. В исследование включили 66 пациентов, которым проводили суточное мониторирование АД с оценкой ригидности артериальной стенки и показателей отраженной волны. Результаты. У больных с гиперальдостеронемией выявлены не только статистически значимое более тяжелое течение АГ, нарушение суточного ритма АД, но также нарушение суточного ритма индекса аугментации (AIx) - преимущественное его повышение в ночные часы. Обнаружена положительная корреляция между AIx в ночные часы и уровнем концентрации альдостерона плазмы в покое (r=-0,31; р=0,002). Заключение. Полученные результаты свидетельствуют о целесообразности суточного мониторирования индекса прироста систолической волны у больных АГ этой категории.
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References

  1. Ruilope L.M. Aldosterone, Hypertension, and cardiovascular disease. Hypertension 2008; 52: 207.
  2. Zelinka T., Wichterle D. Increased intima-media thickness of the common carotid artery in primary aldosteronism in comparison with essential hypertension. J Hypertens 2007; 25: 1451-1457.
  3. Verdecchia P., Schilaci G., Borgioni C. Ambulatory pulse pressure: a ptent predictor of total cardiovascular risk in hypertension. Hypertension 1998; 6 (32): 983-988.
  4. Chopikashvili D.V., Chikhladze N.M., Rogoza A.N. The effects of amlodipine on pulse pressure and aortic stiffness in hypertensive patients with hyperaldosteronism. Hypertension 2004; 22 (2): 3333.
  5. Nürnberger J. Augmentation index is associated with cardiovascular risk. J Hypertens 2002; 20: 2407-2414.
  6. Bia D., Lluberas D., Zocalo S. et al. Circadian pattern and night-day variations in human arterial stiffness: assessment using ambulatory recording of arterial pressure and pulse transit time. IFMBE Proceedings 2008; 18: 82-86.
  7. Rossi Z.L., Calabro A. Prevalence of extracranial carotid artery lesion at duplex in primary aldosteronism. Am J Hypertens 1993; 6: 8-14.
  8. Rossi G.P., Sacchetto A., Visentin P. et al. Changes in left ventricular anatomy and function in hypertension and primary aldosteronism. Hypertension 1996; 27:1039-1045.
  9. Štrauch B., Petrak O., Wichterle D. et al. Increased arterial wall stiffness in primary aldosteronism in comparison with essential hypertension. Am J Hypertens 2006; 19: 909-914.
  10. Štrauch B., Petrak O., Zelinka T. et al. Adrenalectomy improves arterial stiffness in primary aldosteronism. Am J Hypertens 2008; 21: 1086-1092.
  11. London G.M., Blacher J., Pannier B. et al. Arterial wave reflections and survival in end-stage renal failure. Hypertension 2001; 38 (3): 434-438.
  12. Laurent S., Boutouyrie P., Asmar R. et al. Aortic stiffness is an independent predictor of all-cause and cardiovascular mortality in hypertensive patients. Hypertension 2001; 37: 1236-1241.
  13. Boutouyrie P., Tropeano A.I., Asmar R. et al. Aortic stiffness is an independent predictor of primary coronary events in hypertensive patients: a longitudinal study. Hypertension 2002; 39: 10-15.
  14. Kohara K., TabaraY., Oshiumi A. et al. Radial augmentation index: a useful and easily obtainable parameter for vascular aging. Am J Hypertens 2005; 18: 11S-14S.
  15. Gatzka C.D., Kingwell B.A., Cameron J.D. et al. Gender differences in the timing of arterial wave reflection beyond differences in body height. J Hypertens 2001; 19: 2197-2203.
  16. Cameron J.D., McGrath B.P., Dart A.M. Use of radial artery applanation tonometry and a generalized transfer function to determine aortic pressure augmentation in subjects with treated hypertension. J Am Coll Cardiol 1998; 32: 1214-1220.
  17. Yasmin J.D., Brown M.J. Similarities and differences between augmentation index and pulse wave velocity in the assessment of arterial stiffness. Q J Med 2000; 92: 595-600.
  18. Cugini P., Halberg F., Sothern R.B. et al. Circadian pattern of RAAS and therapeutic intervention. Cronobiologia 1985; 12: 155-165.
  19. Rosa J., Šomlóová Z., Petrák O. et al. Peripheral Arterial Stiffness in Primary Aldosteronism. Physiol Res 2012; 61: 461-468.

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