STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE; PUBLIC NON-PROFIT ENTERPRISE «KHMELNYTSKYI REGIONAL СARDIOVASCULAR CENTER» KHMELNYTSKYI REGIONAL COUNCIL, KHMELNYTSKYI, UKRAINE.
STATE INSTITUTION OF SCIENCE «RESEARCH AND PRACTICAL CENTER OF PREVENTIVE AND CLINICAL MEDICINE» STATE ADMINISTRATIVE DEPARTMENT, KYIV, UKRAINE.
Wiad Lek. 2020;73(12 cz 1):2591-2597.
The aim: To examine the association of hypertensive mediated target organ damage with blood pressure visit-to-visit variability in Ukrainian rural dwellers with uncomplicated hypertension.
Material and methods: The cross-sectional study enrolled 160 adult males with uncomplicated primary hypertension (mean age 50±6 yo). We analyzed office systolic and diastolic blood pressure levels, obtained at four consecutive visits. We used standard deviation (SD) value to assess blood pressure visit-to-visit variability. The patients were referred to the group with high (n=82; 51.3%) vs low (n=78; 48.7%) blood pressure variability (HBPV, LBPV).
Results: HBPV patients were characterized by higher left ventricular myocardial mass indexed to height 2.7: median, interquartile range: 70.9 (61.3-78.2) vs 50.9 (44.9-54.4) g/m2.7, respectively p<0.001. The cases of severe left ventricular hypertrophy prevailed in HBPV group (vs LBPV): 68% vs 5%, respectively, p<0.001. HBPV group was characterized by larger common carotid artery intima-media complex thickness, advanced hypertensive retinopathy, higher urine albumin/creatinine ratio value and worse kidneys' glomerular filtration rate. The obtained results might be helpful in the context of global monitoring of vulnerable high risk population of hypertensive rural males.
Conclusions: The HBPV in rural hypertensive males was associated with more pronounced target organ damage. Further regional research on the various clinical aspects of hypertension, including blood pressure variability, might be useful in extending the existed evidence on prevention of hypertension-related complications.
探讨乌克兰农村未经治疗的原发性高血压患者血压变异性与高血压介导的靶器官损害的关系。
本横断面研究纳入了 160 名未经治疗的原发性高血压成年男性（平均年龄 50±6 岁）。我们分析了连续 4 次就诊时的诊室收缩压和舒张压水平。我们使用标准差（SD）值来评估血压变异性。根据血压变异性的高低（高变异组 n=82，51.3%；低变异组 n=78，48.7%）将患者分为两组。
高变异组患者的左心室心肌质量指数（左心室心肌质量除以身高 2.7）显著高于低变异组[中位数（四分位距）：70.9（61.3-78.2）比 50.9（44.9-54.4）g/m2.7，p<0.001]。高变异组更易发生严重左心室肥厚（左心室心肌质量指数>35 g/m2.7）（68%比 5%，p<0.001）。高变异组的颈总动脉内膜中层厚度更大、更严重的高血压性视网膜病变、更高的尿白蛋白/肌酐比值以及更差的肾小球滤过率。这些结果有助于对高危农村男性高血压脆弱人群进行全球监测。
在农村高血压男性中，高血压变异性与更明显的靶器官损害相关。进一步对高血压的各种临床方面（包括血压变异性）进行区域性研究，可能有助于扩大与高血压相关并发症预防相关的现有证据。
