Significance of Microcirculation Abnormalities as Counter-hypotension Mechanism in Essential Arterial Hypertension
The aim of the investigation is to study the contribution of microcirculation abnormalities to “escape effect” development in drug antihypertensive therapy in patients with essential arterial hypertension (AH).
Materials and Methods. There were examined 107 patients with essential AH of the I–II severity degree (49 males, 58 females; their mean age being 48.9±9.9 years). In all patients before and after 8 weeks of drug antihypertensive therapy there was carried out ambulatory blood pressure monitoring, values of central and peripheral circulatory dynamics were determined, and the state of microcirculatory bed was assessed. The patients were divided into three groups by cluster analysis based on initial data and hypotension therapy results.
Results. Against the background of 8 weeks’ drug hypotension therapy in two groups there was achieved sufficient and stable effect, there were observed normalization of central, peripheral circulatory dynamics and circulation. In the third group the result of hypotension therapy was considered as unsatisfactory, there was reveled no improvement of microcirculatory bed state.
Conclusion. Microcirculatory abnormalities appears as counter-hypotension factor leading to “escape effect” development in drug hypotension therapy.
- Chazova I.E. Serdechnaya nedostatochnost’ 2002; 1: 14–16.
- Stampler J., Stampler R., Neaton J. Blood pressure, systolic and diastolic, and cardiovascular risks. Intern Med 1993; 153: 598–615.
- Shal’nova S.A., Balanova Yu.A., Konstantinov V.V. et al. Ross Kardiol Z 2006; 4: 45–50.
- Belenkov Yu.N., Marev V.Yu. Serdechnaya nedostatochnost’ 2002; 1: 7–11.
- Shkarin Vl.V. Sistemnyy podkhod v diagnostike, lechenii i vedenii patsientov s arterial’noy gipertenziey v ambulatornykh usloviyakh. Avtoref. dis. … dokt. med. nauk [Systemic approach in diagnosis, treatment and management of patients with arterial hypertension in the conditions of outpatient department. Abstract of Dissertation for the degree of Doctor of Medical Science]. Nizhny Novgorod, 1999.
- Podzolkov V.I., Bulatov V.A. Serdtse 2005; 3: 132–137.
- Chazova I.E., Boytsov S.A., Nebieridze D.V. Kardiovaskulyarnaya terapiya i profilaktika 2004; 4: 90–98.
- Bodrievskaya I.A. Otsenka stabil’nosti gipotenzivnogo effekta s pomoshch’yu entropiynogo metoda. Avtoref. dis. … kand. med. nauk [Bodrievskaya I.A. Stability evaluation of hypotensive effect using entropic method. Abstract of Dissertation for the degree of Candidate of Medical Science]. Nizhny Novgorod; 2008.
- Shennon K.E. Raboty po teorii informatsii i kibernetike: perevod s angl. [Works on the theory of information and cybernetics: translation from English] Moscow: Mir; 1963; 829 p.
- Gurvich E.V., Shkarin Vl.V. Nizhegor Med Z 2002; 2: 101–106.
- Degtyarev V.A. Rossiyskie meditsinskie vesti 2003; 4: 18–28.
- Mikrotsirkulyatsiya v kardiologii [Microcirculation in cardiology]. Pod red. V.I. Makolkina [V.I. Makolkin (editor)]. Moscow; 2004; 131 p.
- Makolkin V.I., Bran’ko V.V., Bogdanova E.A. et al. Metod lazernoy dopplerovskoy floumetrii v kardiologii [Method of laser Doppler flowmetry in cardiology]. Moscow; 1999.
