ABSTRACT
The work was aimed to study five-year dynamics of characteristics of left ventricular diastolic function in patients with arterial hypertension (AH) under conditions of continuous shiftwork in the Far North. The first stage of the study (2003-2005) involved 95 patients including 53 day-shift ones and 42 subjects working alternately on day and night shifts. At the second stage (2007-2011), prospective observation of both groups using Doppler echocardiography was organized. The patients were divided into 2 subgroups (with treated and untreated AH). It was shown that AH patients in the Far North frequently suffer disturbances of left ventricular diastolic function manifest as increased contribution of left atrial systole to left ventricular filling. This phenomenon was more pronounced in nightshift workers.
Subject(s)
Heart Diseases/physiopathology , Hypertension/physiopathology , Occupational Diseases/physiopathology , Work Schedule Tolerance/physiology , Adult , Arctic Regions/epidemiology , Arterial Pressure/physiology , Diastole/physiology , Echocardiography, Doppler , Female , Heart Diseases/diagnosis , Heart Diseases/epidemiology , Heart Ventricles/physiopathology , Humans , Hypertension/diagnosis , Hypertension/epidemiology , Male , Occupational Diseases/diagnosis , Occupational Diseases/epidemiology , Prospective Studies , Russia/epidemiology , Time FactorsABSTRACT
Five-year observations yielded diurnal profiles of arterial pressure (AP) in practically healthy residents of the north of Tyumen region. Their analysis revealed the enhancement of AP variability in day- and nighttime (especially diastolic AP), elevated rise of morning AP in the absence of adequate decrease of nocturnal AP.
Subject(s)
Arterial Pressure/physiology , Blood Pressure Determination/methods , Circadian Rhythm/physiology , Cold Climate/adverse effects , Adult , Female , Humans , Male , SiberiaABSTRACT
AIM: To study effect of combined therapy with amlodipine with ramipril on the circadian profile of arterial pressure in patients with arterial hypertension in the Far North depending on the shiftwork regime. MATERIALS AND METHODS: 130 patients with grade 2-3 AH were divided into 2 groups depending on the work-time schedule. Group 1 included 67 daywork patients group 2 consisted of 63 patients working in the alternating daywork and nightwork regime. 24 hr AH monitoring was performed before, 4 weeks and 6 months after the onset of the study. RESULTS: Six months after the onset of therapy practically all patients reached the target AD level (94.4% in group 1 and 94.7% in group). The patients fairly well tolerated therapy AD circadian profile was normalized 1.9 times in group 1 and 3.2 times in group 2. Recovered AP variability in group 1 resulted in a decreased frequency of target organ affection. In group 2, the initially higher variability accounted for the normalization of only diastolic AP variability after 6 month therapy. It suggests the necessity of prescription of a third anti-AH preparation to these patients. Morning AP dynamics improved in both groups.
Subject(s)
Amlodipine/administration & dosage , Blood Pressure/drug effects , Circadian Clocks/drug effects , Hypertension , Ramipril/administration & dosage , Adult , Angiotensin-Converting Enzyme Inhibitors/administration & dosage , Calcium Channel Blockers/administration & dosage , Cold Climate , Drug Monitoring/methods , Drug Therapy, Combination/methods , Female , Humans , Hypertension/drug therapy , Hypertension/physiopathology , Male , Middle Aged , Severity of Illness Index , Siberia , Treatment OutcomeABSTRACT
Left ventricular diastolic function (LVDF) was studied in subjects with arterial hypertension (AH) living in the Far North in relation to their working regime. A total of 95 patients with grade I-II AH were divided into two groups, one including 53 dayworkers the other comprising 42 patients working in shifts. The control group included 25 practically healthy subjects. All the patients were examined by Doppler echocardiography. Analysis of the results demonstrated that patients with AH working night shifts more frequently experienced LVDF disturbances than subjects of other groups. These disturbances included increased contribution of the left atrial systole to left ventricle filling. Patients with AH exhibited the well-apparent dependence of left ventricle diastolic filling on the degree of its hypertrophy. LVDF was related to the elevation of nocturnal arterial pressure due to a rise in systolic AP.
Subject(s)
Blood Pressure/physiology , Hypertension/epidemiology , Hypertension/physiopathology , Hypertrophy, Left Ventricular/epidemiology , Hypertrophy, Left Ventricular/physiopathology , Work Schedule Tolerance/physiology , Adult , Atrial Function, Left/physiology , Catchment Area, Health , Echocardiography , Female , Humans , Male , Russia/epidemiologyABSTRACT
Arterial hypertension (AH) is a great part of general mortality and invalidism. The AH problem is especially topical problem for the north Russian regions. In the article was shown, that extremal conditions of Tyumen North played a great role in forming of cardiovascular diseases, especially AH. Features of AH development and clinical course in northerners are reflected.
