Clinical value of circulation type in hypertensive patients

• Main Authors: A. V. Barsukov, A. A. Goryacheva
• Format: Article
• Language: Russian
• Published: «SILICEA-POLIGRAF» LLC 2005-04-01
• Series: Кардиоваскулярная терапия и профилактика
• Subjects: arterial hypertension; hemodynamics type; mental stress; emotion-induced cardiovascular and neurohumoral reactions; antihypertensive therapy
• Online Access: https://cardiovascular.elpub.ru/jour/article/view/927
• ISSN: 1728-8800; 2619-0125

Aim. To investigate stress-induced hemodynamic and neuro-humoral reactions, as well as clinical efficacy of various antihypertensive monotherapies in patients with arterial hypertension (AH) and different hemodynamics types (HT). Material and methods. Effects of dosed intellectual and emotional stress (IES) on central and peripheral hemodynamics parameters, variation pulsometry, stress-adaptive hormones’ levels, were studied in 60 patients with borderline AH (BAH) and hyper- or hypokinetic HT (HyperHT and HypoHT). In 173 middle-aged patients with Stage I-II AH, clinical efficacy of nifedipine, diltiazem, propranolol monotherapy was assessed, according to HT. In 44 young patients with Stage I AH, moxonidine therapy influence on circadian blood pressure (BP) profile was studied. Results. During IES, BAH patients with HyperHT demonstrated a significant increase in cardiac output and adrenaline secretion, patients with HypoHT – an increase in peripheral vascular resistance and noradrenalin concentration. In AH patients with HyperHT, BP level and sympathic hypertonus were effectively corrected by propranolol; in patients with HypoHT, nifedipine and diltiazem were more effective. Moxonidine significantly improved circadian BP profile (pressure load, BP variability, BP nocturnal decline) in individuals with AH and HyperHT. Conclusion. Emotion-induced cardiovascular and neuro-humoral reactions in AH patients are partially explained by their HT. AH patients with HyperHT should be administered sympathico-inhibiting antihypertensives (beta blockers, I1 imidazoline receptor agonists). HypoHT AH patients require vasodilatator therapy, in particular, calcium antagonists.