ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 36 of 67
УЖМБС 2020, 5(3): 267–272
Clinical Medicine

Features of the Course of Endothelial Dysfunction and Disorders of Peripheral Hemodynamics of Patients with Hypertension

Shevchenko M. B., Medvedchuk G. Ya.

The article deals with the urgent problem of cardiology concerning the state of peripheral hemodynamics and endothelial dysfunction in patients with hypertension. Patients with arterial hypertension have vascular stiffness increases, the likelihood of thrombosis increases, and perfusion of vital organs. There is also a violation of the integrity of the endothelium, which, in turn, leads to the progression of atherosclerosis. Together, these mechanisms lead to the development of cardiovascular complications in these patients. Material and methods. The authors examined 54 patients with hypertension with I-III degrees of arterial hypertension without signs of severe heart failure and clinically significant concomitant pathology. The authors used modern research methods. The following parameters were studied: the volumetric blood flow velocity at rest and after a test with reactive hyperemia, followed by the calculation of the coefficient of mechanosensitivity and regional peripheral resistance at rest and after reactive hyperemia. We also studied the plasma level of endothelial vasoactive factors - endothelin-1 (ET-1) and cyclic guanosine monophosphate (cGMP). Results and discussion. As a result of a study we detected patients with hypertension with I-III degrees of arterial hypertension, who had violations of the vasoregulatory function of the vascular endothelium in the early stages of the disease. It was manifested as a decrease in regional blood flow, mechanosensitivity of resistive vessels and an increase in peripheral resistance, as well as a violation of the balance of vasoactive substances (increase in ET-1, decrease in cGMP). In the course of the correlation analysis, we found close relationship between the content of vasoactive factors in blood plasma and peripheral hemodynamics in patients with hypertension as the development of arterial hypertension. Our study showed that high levels of ET-1 suppress NO formation in patients with hypertension, as evidenced by the negative correlation between plasma ET-1 levels and cGMP content in blood plasma (r = -0.41; p <0, 05). Our results are consistent with the literature. Thus, the study by L. Spinarova et al. hypertensive patients showed that plasma ET-1 and its precursor correlated not only with altered hemodynamics but also with values of thromboxane, prostacyclin G, with NO a negative correlation was found. In this way, ET-1 hyperfunction prevents or reduces EGF smooth muscle cell relaxation. We determined a strong negative relationship between the content of ET-1 in blood plasma in patients with hypertension and the rates of regional vascular blood flow OHSKsp and OshKrg (r = -0.52; r = -0.65; p <0.05) and coefficient that determines the sensitivity of resistive vessels (r = -0.64; p <0.05). Conclusion. Thus, it can be noted that with the progression of arterial hypertension under the influence of vasoconstrictors, vascular stiffness increases and hemodynamic disturbances occur, leading to damage to target organs.

Keywords: arterial hypertension, endothelin-1, peripheral resistance

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