[Relationship of variability of blood pressure, cardiac sinus rhythm, and structural and functional characteristics of the left ventricular myocardium in elderly and senile patients with arterial hypertension].

The variability of blood pressure (BP), autonomic cardiac sinus rhythm regulation, and myocardial structural and functional characteristics of the left ventricle (LV) was comparatively analyzed in 201 patients aged 65-88 years who had uncomplicated systolic and diastolic and isolated systolic arterial hypertension (SDAH and ISAH, respectively). There was a greater variability of systolic and diastolic BP no matter what the type of arterial hypertension (AH) was. It was ascertained that ISAH was characterized by absolute parasympaticotonia and SDAH was marked by relative sympaticotonia with the involvement of central ergotropic and humoral-and-metabolic mechanisms. In elderly and senile patients, uncomplicated AH was accompanied in 86.6% of cases by LV remodeling, mainly as its concentric hypertrophy (52.7%), characterizing primarily by non-restrictive diastolic dysfunction. There were no significant differences in the types of LV remodeling and diastolic dysfunction in patients with combined AH and ISAH. Moreover, the development of LV remodeling and associated diastolic dysfunction in SDAH was followed by a decrease in the overall variability of cardiac sinus rhythm with a smaller contribution of a segmental link of the parasympathetic portion of the autonomic nervous system and by the development of relative sympaticotonia due to suprasegmental and humoral-and-metabolic influences.