Saratov JOURNAL of Medical and Scientific Research

Comprehensive evaluation of vascular wall state in patients with arterial hypertension in different periods of ischemic stroke

Year: 2021, volume 17 Issue: №3 Pages: 460-464
Heading: Cardiology Article type: Original article
Authors: Mayorova S.V., Lipatova Т.Е.
Organization: Saratov State Medical University
Summary:

Objective: to assess the indicators of arterial stiffness and endothelial function in patients with arterial hypertension (AH) in different periods of ischemic stroke (IS), depending on the degree of recovery of neurological functions. Material and Methods. We examined 180 patients aged over 40 years with AH in the acute period of IS, admitted to the neurological department from September, 2015 to June, 2019. The degree of functional independence was assessed using the modified Rankin scale (mRS). The patients were divided into 2 groups: group I —with a high level of recovery, mRS<3 (n=88) and group II — with a low level of recovery, mRS>3 (n=92). The oscillometric method was used to assess the average daily indicators of vascular rigidity. The level of endothelin-1 (ET-1), endothelium-dependent vasodilation (ESVD) and occlusion index were investigated. The observation period was 2 months. Results. Group II in the acute period of IS is characterized by higher values of the rigidity of the vascular wall (SPW 13.8±1.8 m/s vs 11.6± 1.7 m/s, p<0.05), an increase in the level of ET-1 (6,5±1.8 ng/ml vs 5.6±1.8ng/ml, p<0.05), decreased EDVD (5.0±1.2% vs 5.9±1.4, p<0.05). After 2 months, there was a positive trend in the studied indicators in both groups. In group II, PWV decreased from 13.8±1.8 m/s to 11.8±1.6 m/s, p<0.05; in group I, PWV decreased from 11.6±1.7 m/s to 9.8±1.5 m/s, p<0.05. Conclusion. Patients with a low restorative potential showed a decrease in endothelial function and higher indicators of vascular rigidity.

Bibliography:
1. The prevalence of risk factors for non-communicable diseases in the Russian population in 2012-2013. The results of the study ESSE-RF. Cardiovascular Therapy and Prevention 2014; 13 (6): 4-11.
2. 2018 ЕОК/ЕОАГ Рекомендации по лечению больных с артериальной гипертензией. Российский кардиологический журнал 2018; 23 (12): 143-228.
3. Pistoia F, Sacco S, Degan D, et al. Hypertension and stroke: epidemiological aspects and clinical evaluation. High Blood Press Cardiovasc Prev 2016; 23 (1): 9-18.
4. Paulo WPires, Carla M, etal. The effects of hypertension on the cerebral circulation. Am J Physiol Heart Circ Physiol 2013; 304(12): H1598—H1614.
5. Rajendran P, Rengarajan T, Thangavel J, et al. The vascular endothelium and human diseases. Int J Biol Sci 2013; 9 (10): 1057-69.
6. Danton GH, Dietrich WD. Inflammatory mechanisms after ischemia and stroke. J Neuropathol Exp Neurol 2003; (62): 127-36.
7. Knottnerus IL, Ten Cate H, Lodder J, et al. Endothelial dysfunction in lacunar stroke: a systematic review. Cerebrovasc Dis 2009; 27 (5): 519-26.
8. Cahill PA, Redmond EM. Vascular endothelium — Gatekeeper of vessel health. Atherosclerosis 2016; (248): 97-109. DOI: 10.1016/j.atherosclerosis.2016.03.007.
9. Palombo C, Kozakova M. Arterial stiffness, atherosclerosis and cardiovascular risk: Pathophysiologic mechanisms and emerging clinical indications. Vascul Pharmacol 2016; (77): 1-7. DOI: 10.1016/j. vph. 2015.11.083.
10. Boutouyrie P, Bussy C, Lacolley P, et al. Association between local pulse pressure, mean blood pressure, and large-artery remodeling. Circulation 1999; (100): pg. 1387-93.
11. Buonacera A, Stancanelli B, Malatino L. Stroke and hypertension: an appraisal from pathophysiology to clinical practice. Curr Vase Pharmacol 2019; 17 (1): 72-84.
12. Lipatova ТЕ, Mikhailova EA, Dudaeva NG. Cardiovascular risk factors and arterial stiffness in patients with ulcerative colitis. Saratov Journal of Medical Scientific Research 2019; 15 (3): 753-7.

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