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№4' 2017

CARDIOLOGY

International Medical Journal, Vol. 23., Iss. 4, 2017, P. 5−12.


DAILY MONITORING OF BLOOD PRESSURE AND STRUCTURAL AND FUNCTIONAL STATE OF THE HEART IN MIDDLE-AGED AND ELDERLY PATIENTS WITH ARTERIAL HYPERTENSION


Kolesnyk T. V., Kosova H. A.

Dnipro Medical Academy, Ministry of Health of Ukraine, Ukraine

Arterial hypertension is an independent and most important factor in cardiovascular disease development and causes a high risk of disabling complications and mortality. The age−related features of changes in daily profile of blood pressure and parameters of the structural and functional state of the heart were determined in middle−age and elderly patients with arterial hypertension using the data of long−term investigation. Assessment of the structural and functional state of the heart was performed using transthoracic echocardiography, a pulse−wave Doppler device by the standard method. The features of daily blood pressure profile were analyzed according to the daily blood pressure findings. After the initial examination all patients were administered antihypertensive therapy in accordance with the recommendations for the diagnosis and treatment of arterial hypertension. Further dynamic observation included daily blood pressure monitoring and echocardiography 3, 6 months and 1 year later. The dynamics of changes in the characteristics of the daily profile of arterial pressure and the structural and functional state of the heart was investigated in middle−aged and elderly patients with arterial hypertension against a background of a long−term treatment. The age−related characteristics of the course of arterial hypertension were determined. In elderly patients, it is advisable to use routine daily blood pressure monitoring to evaluate the effectiveness of the prescribed antihypertensive therapy. Regular dynamic monitoring and evaluation of the effectiveness of the chosen treatment tactics under daily blood pressure control allows not only to reach the target levels of the blood pressure, but also normalize the circadian rhythm of the blood pressure, which improves the prognosis of cardiovascular complications in hypertensive patients, especially in the elderly ones. At reaching the target level of the blood pressure in the group of middle−aged patients, reversion of left ventricle hypertrophy was achieved by 3rd month and the regress of myocardial hypertrophy reached its maximum by the 1st year of treatment. In the elderly patients, normotension can only be achieved at the absence of progress in the level of left ventricle hypertrophy.

Key words: arterial hypertension, daily blood pressure monitoring, left ventricular hypertrophy, left ventricular diastolic dysfunction, elderly age.


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