SKIN MICROCIRCULATORY ORGANIZATION TYPES IN ARTERIAL HYPERTENSION BY THE DATA OF DOPPLER FLOWMETRY
https://doi.org/10.15829/1560-4071-2015-4-7-12
Abstract
Aim. To assess types of functional shifts at the microcirculatory level (MC) in patients with arterial hypertension (AH) with different level of microvascular resistance. Material and methods. Healthy (n=34) volunteers and patients with AH 2-3 grade (n=79) and high (n=30) level of microvascular resistance of the skin were assessed for MC with laser doppler flowmetry.
Results. No matter the comparable level of blood pressure (BP) in groups with AH, the differences of MC pattern in patients with high vascular resistance are the same and present with a venous congestion resulting in an intensification of arterial-venular shunting of the blood and decreased venous backflow. As the load of the blood coming into microcirculatory stream in the AH groups investigated is identical, constriction of precapillares and dumping of blood by shunts is related to significant decrease of nutritive blood flow. Negative character of microhaemocirculation in this case is confirmed by the higher prevalence of worse prognostic types of hemodynamics and higher microalbuminuria level.
Conclusion. Decreased nutritive productivity of MC in patients with high microvascular resistance suggests more prominent negative influence on target organs that requires more active hypotensive therapy with consideration of MC shifts. Also the expediency cannot be disregarded of the inclusion of strong vasolytic agents in complex therapy.
About the Authors
A. P. Vasiliev
Filial of FSBI Scientific-Research Institute of Cardiology of Siberian department of RAS Tyumen cardiological center, Tyumen, Russia.
Russian Federation
Russian Federation
N. N. Streltsova
Filial of FSBI Scientific-Research Institute of Cardiology of Siberian department of RAS Tyumen cardiological center, Tyumen, Russia.
Russian Federation
Russian Federation
M. A. Sekisova
Filial of FSBI Scientific-Research Institute of Cardiology of Siberian department of RAS Tyumen cardiological center, Tyumen, Russia.
Russian Federation
Russian Federation
References
1. Kolandaivelu К, Leiden BB, O'Gara PT, et al. Non-adherence to cardiovascular medications. European Heart Journal 2014; 35: 3267-76.
2. Nelson MR, Reid CM, Ryan P, et al. Self-reported adherence with medication and cardiovascular disease outcomes in the Second Australian National Blood Pressure Study (ANBP2). Med J Aust. 2006; 185:487-8.
3. Chowdhury R, Khan H, Heydon E, et al. Adherence to cardiovascular therapy: a meta-analysis of prevalence and clinical consequences. Eur Heart J. 2013; 34(38): 2940-8.
4. Sokol MC, McGuigan KA, Verbrugge RR, et al. Impact of medication adherence on hospitalization risk and healthcare cost. Med Care. 2005; 43(6): 521-30.
5. Morisky DE, Green LW, Levine DM. Concurrent and predictive validity of a self-reported measure of medication adherence. Med Care 1986; 24(1): 67-74.
6. Corrao G, Zambon A, Parodi A, et al. Discontinuation of and changes in drug therapy for hypertension among newly-treated patients: a population-based study in Italy. J Hypertens. 2008; 26(4): 819-24.
7. Burke ТА, Sturkenboom MC, Lu SE, et al. Discontinuation of antihypertensive drugs among newly diagnosed hypertensive patients in UK general practice. J Hypertens. 2006; 24(6):1193-200.
8. Wong MC, Tarn WW, Cheung CS, et al. Initial antihypertensive prescription and switching: a 5 year cohort study from 250,851 patients. PLoS One. 2013; 8(1): e53625.
9. Chou CC, Lee MS, Ke CH, et al. Factors influencing the switch inthe use of antihypertensive medications. Int J Clin Pract. 2005; 59(1): 85-91.
10. Mazzaglia G, Mantovani LG, Sturkenboom MC, et al. Patterns of persistence with antihypertensive medications in newly diagnosed hypertensive patients in Italy: a retrospective cohort study in primary care. J Hypertens. 2005; 23(11): 2093-100.
11. LihachevSA, Lushhik AV. Arterial hypertension and adherence to antihypertensive therapy according to population research. Bjulleten' medicinskih internet-konferencij (ISSN 2224-6150) 2014; 4(2): 103. Russian (Лихачев С.А., Лущик А.В. Артериальная гипертензия и приверженность антигипертензивной терапии по данным популяционного исследования. Бюллетень медицинских Интернет конференций (ISSN 2224 6150) 2014; Том4, №2:103).
12. Olejnikov VJe, Eliseeva IV, Tomashevskaja JuA, et al. Efficiency of antihypertensive therapy at elderly patients and the analysis of adherence to treatment. Racional'naja Farmakoterapija v Kardiologii 2014; 10(4): 391-6. Russian (Олейников В.Э., Елисеева И.В., Томашевская Ю.А. и др. Эффективность антигипертензивной терапии у пожилых пациентов и анализ приверженности лечению. Рациональная Фармакотерапия в Кардиологии 2014; 10(4): 391-6).
13. Degli Esposti E, Surani A, DiMartino M, et al. Long term persistence with antihypertensive drugs in new patients.J Hum Hypertens. 2002; 16:439-44.
14. Patel BV, Remigio-Baker RA, Thiebaud P, et al. Improved persistence and adherence to diuretic fixed-dose combination therapy compared to diuretic monotherapy. BMC Family Practice. 2008; 9: 61.
15. Konobeeva EV, Shvarc JuG, Korsunova EN, et al. Possibilities of increase the conscious motivation of patients cardiac profile. Using standard visual recommendations. Fundamental'nye issledovanija 2013; 9,part 1: 58-61. Russian (Конобеева Е.В., Шварц Ю. Г., Корсунова Е. Н. и др. Возможности повышения осознанной мотивации пациентов кардиологического профиля. Использование стандартных наглядных рекомендаций. Фундаментальные исследования 2013; 9, часть 1:58-61).
Review
For citations:
Vasiliev A.P., Streltsova N.N., Sekisova M.A. SKIN MICROCIRCULATORY ORGANIZATION TYPES IN ARTERIAL HYPERTENSION BY THE DATA OF DOPPLER FLOWMETRY. Russian Journal of Cardiology. 2015;(4):7-12. (In Russ.) https://doi.org/10.15829/1560-4071-2015-4-7-12
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