Hemodynamic load on the intracranial arterial system in subjects who have suffered a hemorrhagic stroke as a complication of essential arterial hypertension
Keywords:arterial hypertension, hemorrhagic stroke, 24-hours ambulatory blood pressure monitoring, ultrasonography of the large cervical arteries, hemodynamic load
The aim of the investigation was to compare a hemodynamic load on the intracranial arterial system, assessed by the indices of 24-hours ambulatory blood pressure monitoring and ultrasonography of the large cervical arteries between the group of patients with essential arterial hypertension in ≥6 months after a hemorrhagic stroke and a group of patients with essential arterial hypertension without complications. The first one was the main group (n=94; age – 54.4±0.9 years), М±m), the second one – the comparison group (n=104; age – 53.7±0.9 years). The indices of 24-hours ambulatory blood pressure monitoring in the main group and the comparison group were the following: the mean daytime systolic blood pressure was 109.6±1.6 and 121.1±1.1 mm Hg, the minimal one was 74.4±2.0 mm Hg and 82.3±12.5 mm Hg, and the maximal one was 168.2±1.9 and 161.9±1.7 mm Hg, p<0.05. The daytime systolic blood pressure sigma (17.9±0.6) and the average real variability of systolic blood pressure (11.31±2.52 mm Hg) were bigger in the main group (p<0.01). The daytime index of hyperbaric load of systolic blood pressure was bigger in the main group: it was 403.6±25.9 against 231.7±12.1 mm Hg × h in the comparison group (p<0.01). The maximal pulse pressure for a 24-hours interval was 74.2±2.0 and 66.4±0.9 mm Hg, respectively (p<0.01). The indices of ultrasonography of the large cervical arteries in the right and left vessels of the main group were the following: the Gosling's pulsatility index was 1.578±0.059 and 1.552±0.042 for the common carotid artery, 1.210±0.044 and 1.102±0.037 for the internal carotid artery, 1.191±0.030 and 1.150±0.023 for the vertebral artery. The above-mentioned indices were bigger in the main group than in the comparison one (p<0.01). The diameters of all the large cervical arteries were bigger in the main group (p<0.01). Therefore, according to the above-mentioned indices which are associated with a bigger risk of cerebrovascular events, a bigger hemodynamic load on the intracranial arterial system was found in the main group than in the comparison one, despite the smaller mean systolic blood pressure indices.
Antomonov MY. [Mathematical processing and analysis of biomedical data]. Kyiv: Medinform; 2017. p. 578. Russian. Available from: http://www.health.gov.ua/www.nsf/16a436f1b0cca21ec22571b300253d46/522e94120f630ce5c225803b004b3867/$FILE/Antomonov_monogr_titul%2BOGLAVL%2Bvvedenie.pdf
Glushko AV, Lytvynenko NV. [Clinical and haemostatic characteristics in the debut of hemorrhagic stroke]. Aktualni problemy suchasnoi medytsyny. 2016;16(part 2. 54):75. Ukrainian. Available from: https://cyberleninka.ru/article/n/kliniko-gemostaziologichni-harakteristiki-v-debyuti-gemoragichnogo-insultu/viewer
Sirenko Yu M, Mishchenko LA, Yena LM, Ko¬val SM, Radchenko HD, Rekovets OL. [Classification and standards of medical care for patients with arterial hyper¬tension from the Association of Cardiologists of Ukraine]. Arterialna hipertenziia. 2018;4(60):26-47. Russian.
Boiev SS, Dotsenko MIa, Herasymenko LV, She¬khunova IO, Molodan OV, Malynovska OIa. [Evaluation of the prognostic significance of the intima-media thickness of the carotid artery and the nature of the course of arterial hypertension in the definition of cognitive dysfunction]. Arterialna hipertenziia. 2018;3(59):7-13. Ukrainian. doi: http://dx.doi.org/10.22141/2224-1422.214.171.1248.139902
Emiroglu MY, Evlice M, Akcakoyun M, Velioglu M, Agca M, Topal YK, Kargin R, Caliskan M. Effects of Obstructive Carotid Artery Disease on Ocular Circulation and the Safety of Carotid Artery Stenting. Heart Lung Circ. 2017;10:1069-78. doi: https://doi.org/10.1016/j.hlc.2016.11.020
Elwertowski M, Małek G. Standards of the Polish Ultrasound Society - update. Examination of extracranial carotid and vertebral arteries. J Ultrason. 2014;57:179-91. doi: https://doi.org/10.15557/JoU.2014.0018
Satoshi Iimuro et al. Hyperbaric area index calcu¬lated from ABPM elucidates the condition of CKD patients: the CKD-JAC study. Clin Exp Nephrol. 2015;19(1):114-24.
Olesen TB, Stidsen JV, Blicher MK, et al. Impact of Age and Target-Organ Damage on Prognostic Value of 24-Hour Ambulatory Blood Pressure. Hypertension. 2017;70(5):1034-41. doi: https://doi.org/10.1161/HYPERTENSIONAHA.117.09173
Kirkpatrick LA, Feeney BC. A Simple Guide to IBM SPSS: for Version 22.0. Cengage Learning, 2014;128. Available from: https://books.google.com.ua/books/about/A_Simple_Guide_to_IBM_SPSS_for_Version_2.html?id=0489BAAAQBAJ&redir_esc=y
Laurent S, Boutouyrie P. The structural factor of hypertension large and small artery alterations. Circu¬lation Research. 2015;116:1007-21. doi: http://doi.org/10.1161/CIRCRESAHA.116.303596
Mena LJ, Felix VG, Melgarejo JD, Maestre GE. 24-hour blood pressure variability assessed by average real variability: a systematic review and meta-analysis. Journal of the American Heart Association. 2017 Oct 6;10. doi: https://doi.org/10.1161/jaha.117.006895
Polak JF, Herrington D, O'Leary DH. Associations of edge-detected and manual-traced common carotid artery intima-media thickness with incident peripheral artery disease: The Multi-Ethnic Study of Atherosclerosis. Vasc Med. 2019;4:306-12. doi: https://doi.org/10.1177/1358863X19835925
Mach François, Baigent Colin, Catapano Alberico L. et al. 2019 ESC/EAS Guidelines for the management of dyslipidaemias: lipid modification to reduce cardio¬vascular risk. European Heart Journal. 2019:1-78. doi: https://doi.org/10.1093/eurheartj/ehz455
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