NEW APPROACH TOWARDS THE INTEGRAL ASSESSMENT OF CARDIOVASCULAR STATUS IN PATIENTS WITH ARTERIAL HYPERTENSION

Aim. To assess the potential of the integral assessment of cardiovascular system status in patients with arterial hypertension (AH), based on the evaluation of the parameters of microcirculation (non-invasive digital capillaroscopy) and  macrocirculation (pulse wave velocity (PWV) and endothelial function).
Material and methods. The study included 188 people aged 40 years and older:
32 patients with systolic blood pressure (BP) levels 120–139 mm Hg (“PreAH”
group), 36 patients with Stage 1–2 AH (“AH” group), and 85 AH patients who
achieved target BP levels due to antihypertensive therapy (“Treated AH” group). The
control group included 35 healthy volunteers, without any signs or symptoms of
cardiovascular disease (“Healthy” group). All participants underwent clinical and
laboratory examination, including office BP measurement, 24-hour BP monitoring,
and echocardiography, the assessment of nailfold microcirculation, pulse wave
velocity, endothelial function, as well as the measurement of BP and heart rate.
Results. There was an increase in remodelling coefficient (Cv/a) in the groups
“PreAH”, “AH”, and “Treated AH”, compared to the “Healthy” group. PWV levels were
significantly higher in “PreAH” and “Treated AH” groups than in the “Healthy” group.
Based on micro- and macrocirculation parameters assessed, the integral index of
cardiovascular status was calculated. The values of this index were significantly higher in the “AH” group. Effective antihypertensive treatment was associated with a
reduction in these values.
Conclusion. Based on the assessment of a range of micro- and macrocirculation
parameters in AH patients, the integral index of cardiovascular status had been
developed.
This index satisfactorily reflects the dynamics of micro- and macrocirculation in treated
AH and, therefore, can be used as an indicator of effective antihypertensive therapy.
The complex assessment of macro- and microcirculation provides an opportunity
for early AH detection.

capillaroscopy, pulse wave velocity, endothelial function, integral index, prehypertension, arterial hypertension

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