[Changes in pulse wave velocity in the reactive hyperemia as a method of evaluation of endothelial vasomotor function in hypertensive patients].

AIM: To assess the method of pulse wave velocity (PWV) measurement in reactive postocclusion hyperemia test for investigation of vasomotor endothelial function (VEF) in hypertension patients. MATERIAL AND METHODS: A total of 50 hypertensive patients participated in the study: 40 patients (age 20-72 years, 19 females, 21 males) with arterial hypertension of degree I-III with moderate and high risk and 2-30 year duration of the disease and 10 healthy normotensive 20-50 year old males (a control group). VEF was evaluated by two methods: ultrasound test with reactive hyperemia according to D.S. Celermajer (Vivid 7 unit) and measurement of PWV in the test of reactive postocclusive hyperemia on the arteries of the upper limbs (VaSera VS-1000 device). RESULTS: According to the ultrasound method, flow-dependent vasodilatation (FDVD%) in hypertensive patients was 15.0 to 5.8% (mean 3.8 +/- 0.9%) and was lower than in healthy persons (16.0 to 8.0, mean 11.6 +/- 0.8%, p < 0.001). Endothelial dysfunction (FDVD < 6%) was found in 20 (67%) hypertensive patients. In reactive postocclusion hyperemia control group demonstrated PWV lowering and its relative changes (delta PWV%) was 124 to 5.3% (mean 8.8 +/- 0.9%). In hypertensive patients delta PWV% ranged from 11.8 to 5.9% (mean 4.9 +/- 0.8%) that is lower than in healthy subjects (p = 0.001). The linear regression analysis has revealed a positive correlation between FDVD and delta PWV (r = 0.54; p = 0.0003). In delta PWV = 5.1% sensitivity and specificity of the method for detection of VEF disturbance were 65 and 90%, respectively. CONCLUSION: The technique of PWV measurement in the reactive postocclusion hyperemia test with satisfactory sensitivity and specificity can be used in hypertensive patients for detection of VEF defects in the arteries of the upper limbs.

[The circadian profile of the arterial pressure and the structural-functional changes in the cardiovascular system in the initial stage of hypertension]. / Sutochnyi profil' arterial'nogo davleniia i strukturno-funktsional'nye izmeneniia serdechno-sosudistoi sistemy pri nachal'noi stadii gipertonicheskoi bolezni.

24-h blood pressure (BP) monitoring conducted in 52 patients with mild to moderate essential hypertension have shown that the average 24-h systolic and diastolic BP correlates with left ventricular (LV) mass index, while at casual clinical measurements only systolic BP correlates with LV mass index. In non-dippers (patients with a nocturnal BP decrease less than 10%) LV hypertrophy is observed 2 times more often than in dippers (patients with a nocturnal BP decrease more than 10%). In the group of dippers 24-h variability of systolic BP and daily systolic BP correlate with LV mass index. Increased variability of night BP correlates with increased venous tone in the calf, increased structural component of vascular resistance and a reduction of blood flow reserve in lower extremities.

[Blood pressure variability (based on 24-hour monitoring data) in mild arterial hypertension]. / Variabel'nost' arterial'nogo davleniia (po dannym 24-chasovogo monitorirovaniia) pri miagkoi arterial'noi gipertonii.

To evaluate the condition of target organs in patients with mild arterial hypertension (MAH) under normal and high arterial pressure variability (APV), the authors examined 84 MAH males aged 40-60 and 14 matched healthy controls. At 24-h monitoring it was revealed that 32% of MAH patients had high variability of daytime and night arterial pressure which occurred more frequently in atherosclerotic lesion of extracranial carotid artery portions. MAH patients with high APV against those with normal APV develop carotid artery atherosclerosis 3.5 times more frequently, vascular disorders of the fundus of the eye stage II with angiosclerosis and thickening of the interventricular septum 2.5 and 1.8 times more frequently, respectively.

[The effect of the stabilization of a drop in pressure in the arteries during changes in the rate of blood flow]. / Effekt stabilizatsii padeniia davleniia v arteriiakh pri izmeneniiakh skorosti techeniia krovi.

The saphenous artery was joined with the femoral vein in rats. The pressure drop was measured between the aortic arch and the distal end of the saphenous artery. The stabilization of the pressure losses during the increase of blood flow rate occurs and is determined by dilation mainly of the saphenous artery, the degree of this dilation being such that the pressure drop within the wide range of blood flow rate remain constant.

[The effect of an endothelium-dependent stabilization of a pressure drop in small arteries]. / Effekt éndoteliizavisimoi stabilizatsii perepada davleniia na malykh arteriiakh.

In the experiments on rats the authors showed that the discovered effect of pressure drop stabilization in the supplying arteries in changes of the blood flow was also noted in separate subcutaneous arteries. It was also observed that in functional injury of endothelium by 0.3% solution of H2O2 this effect disappears.