Subclinical hypothyroidizm and essential arterial hypertension: features of daily profiles of arterial stiffness in comorbid patients

• Main Authors: Liaisan A. Andreeva, Liudmila A. Panchenkova, Ekaterina A. Troshina, Khadizhat A. Khamidova, Aida M. Gagieva
• Format: Article
• Language: Russian
• Published: ZAO "Consilium Medicum" 2019-04-01
• Series: Consilium Medicum
• Subjects: arterial hypertension; comorbid; arterial stiffness; pulse wave velocity; reflected wave transit time; arterial stiffness index; vascular age
• Online Access: http://consilium.orscience.ru/en/archive/2019/vol-21-4-2019/subclinical-hypothyroidizm-and-essential-arterial-hypertension-features-of-daily-profiles-of-arteria_5457/?element

Aim. To identify the features of the daily dynamics of arterial stiffness in patients with essential arterial hypertension (EАH) and subclinical hypothyroidism (SH). Material and methods. The study involved 78 patients with EAH aged 50 [42; 54] years, divided into 2 groups: AH – 48 (61.5%) and AH+SН – 30 (38.5%). The control group (CG) consisted of 30 healthy individuals, comparable in age and sex. All subjects underwent 24-hour daily monitoring of blood pressure (BPLab Vasotens, Russia) with recording daily arterial stiffness indicators: pulse wave velocity, PWVao; reflected wave transit time, RWTT; arterial stiffness index, ASI. The time index of the normal PWV (Pulse Time Index of Norm – PTIN) was calculated as a percentage of the 24-hour period during which the PWV does not exceed 10 m/s. The calculation of vascular age was carried out according to the Framingham SCORE risk scale modified according to D’Agostino. The comorbidity index was determined on a Charlson scale. Results. Analysis of the daily dynamics of arterial stiffness in patients with EAH and the presence of endocrine pathology showed that SН have a negative effect on elastic properties of the arteries, which is confirmed by significantly higher values of PWVao and arterial stiffness index, ASI, including at night, as well as lower PTIN indices compared with patients with isolated EAH. It can also be assumed that the worsening of arterial stiffness in the group of patients with AG+SН is more pronounced, given the significantly higher vascular age in this group of patients, associated with an increase in the number of comorbid pathology, compared with the AН group. Conclusion. The most pronounced deterioration of diurnal arterial stiffness indicators in the group of comorbid patients with EAH and SН, as well as the excess of vascular age over chronological and reliable correlation with the comorbidity index, revealed during the study, suggests an assessment of these indicators in patients with cardioendocrine pathology to assess the true risk cardiovascular complications and the selection of adequate therapy.