[Analysis of 24-hour blood pressure profile, heart rate variability and carotid atherosclerosis in hypertensive patients among native and nonnative population living in Yamalo-Nenets autonomous district].

OBJECTIVE: To study special characteristics of the course of arterial hypertension (AH) among native and nonnative population of Yamalo-Nenets autonomous district. MATERIAL AND METHODS: We examined 100 residents of Far North with AH (men and women aged 21-55, mean age 44.08 ± 1.15 years). All patients were divided into 2 equal groups by 50 subjects: group I consisted of representatives of native and group II--nonnative population. Examination was carried out in outpatient clinic in Salekhard and included 24-hour ambulatory blood pressure monitoring (ABPM), registration of heart rate variability, duplex scanning of brachiocephalic arteries, and assessment of blood lipid profile. The groups were matched by age, gender and disease duration. RESULTS: Analysis of heart rate variability detected significant degree of strain of regulatory systems in most patients of both groups. According to results of ABPM "non-dipper" patients prevailed in group I compared to group II (p = 0.01). Common carotid artery intima-media complex was significantly greater compared to normal value in all patients; it was thicker in group I (p < 0.03), but number of carotid artery stenoses was similar in both groups. No dyslipoproteinemia was detected. CONCLUSION: Compared with group of representatives of nonnative (adopted) population group of native subjects with AH was characterized by greater carotid intima media thickness and prevalence of "non-dipper" patients.

[Comparative characteristics of carotid atherosclerosis in patients with hypertension concurrent with chronic coronary heart disease among the indigenous and non-indigenous population of the Yamal-Nenets Autonomic District].

AIM: To evaluate the degree of carotid artery (CA) atherosclerotic lesion and lipid metabolic disturbances in patients with hypertension and in those with hypertension concurrent with coronary heart disease (CHD) in the indigenous and non-indigenous population living in the Yamal-Nenets Autonomic District. SUBJECTS AND METHODS: Two hundred men and women aged 21 to 55 years (mean age 48.2 ± 0.7 years), who resided in the Far North, were examined. The patients were divided into 4 gender-and age-matched groups of 50 persons in each: 1) natives; 2) newcomers with hypertension only; 3) natives with CHD and hypertension; 4) non-natives with the above conditions. To study CA involvement, all the patients underwent duplex scanning of the brachiocephalic arteries at the extracranial level and blood lipid analysis in an outpatient setting (Salekhard). RESULTS: In all the patients, common CA intima-media thickness was significantly greater than the upper limit of the normal range defined in the Guidelines, this indicator proved to be highest in the groups of indigenous people (p<0.001). The latter with CHD and hypertension more commonly tended to have atherosclerotic lesion in the left CA (p=0.06) than the non-indigenous people whereas the number of stenosis in other CAs was similar. In the natives versus the newcomers with CHD and hypertension, the atherogenic blood lipid composition was due to the higher levels of total cholesterol and low-density lipoproteins. In the non- indigenous patients with CHD and hypertension, the atherogenicity of the blood lipid composition was characterized by the higher levels of triglycerides (p=0.04) and very low-density lipoproteins (p=0.02) with the lower concentrations of high-density lipoproteins as compared to those in the natives with CHD and hypertension.

[Comparative characteristics of 24-hour blood pressure profile and heart rate variability in indigenous and non-indigenous patients with chronic coronary heart disease and hypertension from the Yamal-Nenets Autonomic District].

AIM: To investigate the specific features of a 24-hour blood pressure (BP) profile and heart rate variability (HRV) in the indigenous peoples (Nenets, Khanty, Selcups, and Komis) and newcomers with chronic coronary heart disease (CHD) and hypertension, who lived in the Yamal-Nenets Autonomic District. SUBJECTS AND METHODS: Two hundred male and females patients aged 21 to 55 years (mean age 48.2 +/- 0.7 years) with chronic CHD and hypertension, who resided in the Far North, were examined. All the patients were divided into 4 groups: (1) 50 aboriginal patients with hypertension only; (2) 50 newcomers with hypertension only; 3) 50 natives with chronic CHD and hypertension; (4) 50 non-natives with the above conditions. The groups were matched for gender, age, and the duration of hypertension and CHD. To study the nature of changes in the 24-hour BP profile, all the patients underwent 24-hour ambulatory BP monitoring (ABPM) and HRV examination. RESULTS: The HRV analysis revealed that all the groups had increases in sympathetic autonomic nervous system (ANS) activity (88% in Group 1; 96% in Group 2; 94% in Group 3, and 92% in Group 4) and decreases in parasympathetic ANS activity (76% in Group 1; 74% in Group 2; 78% in Group 3; and 72% in Group 4), which was suggestive of neurocardiopathy. Analyzing the data of 24-hour ABPM showed that among the natives, there were more patients with increased systolic and diastolic BP (SBP and DBP) variability and higher nocturnal SBP time index (TI). These groups also showed a preponderance of patients with abnormal 24-hour BP profiles as compared to the groups of newcomers (p = 0.034). Among the latter, there were more patients with higher SBP and DBP variability and increased daytime DBP TI and also more patients with a normal nocturnal BP reduction (p = 0.012). CONCLUSION: The group of indigenous populations displayed a predominance of non-dippers and night-pickers and higher nocturnal SBP and DBP whereas the group of non-indigenous ones exhibited a preponderance of dippers and higher daytime SBP and DBP variability.

[Results of duplex scanning of brachiocephalic arteries and estimation of the lipid spectrum in coronary heart disease and arterial hypertension in indigenous and alien population of Yamalo-Nenetsky Autonomous District].

The work aimed at studying atherosclerotic lesions in brachiocephalic arteries and lipid spectrum in coronary heart disease (CHD) and arterial hypertension (AH) in indigenous and alien population of Yamalo-Nenetsky Autonomous District. It included 200 patients with CHD and AH (men and women aged 21-55 years, mean 48.2 +/- 07 yr). They were allocated to indigenous and alien groups (100 persons each). The patients matched for age and sex were examined by duplex scanning based at an outpatient facility (Salekhard). The indigenous population showed more pronounced thickening of the intima-media complex (IMC) of the common carotid artery (p = 0.001) and more frequent lesions of the main head arteries with stenosis of different severity (especially in internal carotid arteries). Total cholesterol, LDLP and atherogenicity index were similar in both groups and higher than normal. Indigenous subjects had less atherogenic structure of the lipid spectrum due to lower TG and VLDLP but higher HDLP levels.

[Cardiac rhythm variability during active orthostatic test in patients with arterial hypertension].

The aim of the study was to evaluate cardiac rhythm variability (CRV) during active orthostatic test (AOT) in patients with arterial hypertension (AH) living in Tyumen near-Ob region. Fifty-two patients with AH and 32 practically healthy persons were examined. Under outpatient conditions in the city of Pyt-Yakh, 5-min CRV recording was performed by standard technique in the supine position and during AOT, and temporary and spectral parameters were evaluated. In both groups, parameters of the temporary analysis of CRV during AOT differed significantly. The values of optimal variability in AH patients displayed significant deviations, while the deviations in the control group were moderate. Analysis of spectral parameters of CRV during AOT revealed an increase in the values of total spectrum power of CRV in both groups. The values of optimal CRV parameters evidenced the presence of disbalance in the vegetative regulation of cardiac rhythm in the subjects. The results of temporary analysis found a lowered activity of parasympathetic vegetative regulation, while spectral analysis revealed an increased sympathetic influence on cardiac rhythm. The values of the index of regulatory system tension during AOT suggest that in both groups the adaptive abilities of the mechanisms of vegetative regulation of cardiac rhythm were preserved.

[Heart rate variability in hypertensive patients living in the region of Tyumen Ob].

AIM: To examine heart rate variability (HRV), some biochemical and echocardiographic indices in hypertensive patients living in the Tyumen Ob region. MATERIAL AND METHODS: Registration of HRV, blood count and echocardiography were made in natural conditions of the North in 52 hypertensive patients (36 males, 16 females, age 20-50) living in Tyumen Ob region and 32 healthy controls (19 males, 13 females) matched by age and residence. RESULTS: Time and spectrum analyses of HRV indices show predominance of the sympathetic link of heart rhythm autonomic regulation in hypertensive patients. Night shifts affect the activity of the sympathetic link of heart rate autonomic regulation destroying its circadian pattern both in hypertensive and normotensive patients. CONCLUSION: Healthy persons initially experience overactivity of the regulatory systems and have the risk for cardiovascular diseases. Working at night shifts accelerates functional exhaustion.

[Development and course of arterial hypertension based on 24-hour monitoring of arterial pressure in a population of the Tyumen region]. / Razvitie i techenie arterial'noi gipertonii po dannym sutochnogo monitorirovaniia arterial'nogo davleniia v usloviiakh Tiumenskogo priob'ia.

Arterial pressure (AP) was monitored in 46 patients with arterial hypertension (AH) aged 18-50 years and in 33 healthy subjects living in Russian North (Tyumen Ob area, Nyagan). The comparison group consisted of 55 patients with AH and 33 healthy subjects living in a moderate climatic zone (Tyumen). The groups were comparable by gender, age, duration of AH, office systolic and diastolic AP (SAP and DAP). Healthy subjects of Tyumen North compared to those living in the moderate climate had more pronounced vegetative imbalance which may transform into AH. The North AH is characterized by high meteorability, impaired circadian AH profile with reduction of the SAP fall day-night and an increase of the DAP fall, greater variability of AP, elevated AP day load, low night DAP. This classifies AH in the northerners as isolated systolic. While AH development in the North takes place due to marked AP fluctuations, in moderate climate it follows a classic variant--due to a DAP rise. The above changes may help prognosis of emergence of cardiovascular complications in hypertensive patients living in the North.

[Daily profile of arterial pressure in patients with arterial hypertension, continuously living in Tyumen polar region]. / Sutochnyi profil' arterial'nogo davleniia u bol'nykh arterial'noi gipertoniei, postoianno prozhivaiushchikh v usloviiakh tiumenskogo pripoliar'ia.

AIM: To study a 24-h profile of arterial hypertension and affection of target organs in hypertensive population of the Tyumen North. MATERIAL AND METHODS: 62 patients (43 men and 19 women, age 18-50 years) with arterial hypertension (AH) living in the North of the Tyumen region entered the test group. The control group consisted of 56 AH patients (36 men and 20 women) matched by age. They lived in the zone of moderate climate (in Tyumen). 24-h arterial pressure (AP) monitoring was made starting on day 2 of the patients' arrival in Tyumen. Echocardiography was made on the arrival day. The examination of the groups was conducted against "clean" background. RESULTS: The groups did not differ significantly by age, sex, AH duration, office systolic and diastolic pressure (SP, DP). However, 37 patients from the test group on arrival in Tyumen showed normalization of both office AP and mean 24-h AP. 25 patients from this group sustained high office and mean 24-h AP. An abnormal 24-h AP profile with nocturnal hypertension was recorded in 76.6% of the test group and 28.31% patients of the control group. Left ventricular hypertrophy was significantly more pronounced in the test group than in the control one. CONCLUSION: In 2/3 patients from the North with AH stage 1 and 2 office AP and mean 24-h AP normalized upon their arrival to the zone of moderate climate but their left ventricular hypertrophy was more severe and changes in a 24-h AP profile with nocturnal hypertension persisted.

[Characteristics of circadian rhythms of arterial pressure and heart rate in hypertensive subjects living in the North of the Tiumen' region]. / Osobennosti tsirkadiannykh ritmov arterial'nogo davleniia i chastoty serdechnykh sokrashchenii u bol'nykh arterial'noi gipertoniei, postoianno prozhivaiushchikh v usloviiakh Tiumenskogo Pripoliar'ia.

Chronostructure of arterial pressure (AP) and heart rate (HR) was studied in 62 residents of Tumen Region North with arterial hypertension (AH) aged 18-50 years and 56 AH controls living in the temperate zone. The groups were matched by age, sex, AH duration, office systolic and diastolic arterial pressure (SAP and DAP, respectively). Circadian AP profile with night hypertension was registered in 76.6 and 28.3% patients of the test and control groups, respectively. Test group patients had more pronounced defects in DAP and HR chronostructures. Thus, AH patients living in the Tumen North demonstrate abnormal circadian AP profile and AP and HR chronostructure. This may be prognostically important for development of cardiovascular complications.