The Autonomic Regulation of Circulation and Adverse Events in Hypertensive Patients during Follow-Up Study

Oleg V Mamontov; Andrey V Kozlenok; Alexei A Kamshilin; Evgeny V Shlyakhto

doi:10.1155/2019/8391924

The Autonomic Regulation of Circulation and Adverse Events in Hypertensive Patients during Follow-Up Study

Cardiol Res Pract. 2019 Dec 30:2019:8391924. doi: 10.1155/2019/8391924. eCollection 2019.

Authors

Oleg V Mamontov^{1

2}, Andrey V Kozlenok¹, Alexei A Kamshilin³, Evgeny V Shlyakhto^{1

2}

Affiliations

¹ Dept. of Circulation Physiology, Almazov National Medical Research Centre, St. Petersburg 197341, Russia.
² Dept. of Departmental Therapy, Pavlov First Saint Petersburg State Medical University, St. Petersburg 197022, Russia.
³ Faculty of Applied Optics, ITMO University, St. Petersburg 197101, Russia.

Abstract

Purpose: Comprehensive study of autonomic regulation assessed during follow-up could provide new detailed information about the risks stratification for hypertensive patients. Therefore, we investigated the associations of these indices with death, stroke, and revascularization during the follow-up observation of 55 patients.

Methods: All patients were with target organ damage, and 27 of them had associated clinical conditions (ACC). Mean age of patients with and without ACC was 62.6 ± 4.2 and 51.9 ± 9.9 (mean ± SD) years, respectively. Follow-up was from 66 to 95 months. At entry, autonomic regulation was assessed by the tilt test, Valsalva maneuver, hand-grip test, and cold-stress vasoconstriction. Hemodynamic parameters were measured by continuous blood pressure monitoring, occlusion plethysmography, and electrocardiography. Re-examination of patients was carried out by questioning and physical and laboratory examination.

Results: We found that fatal outcomes were associated with a lower Valsalva index (1.34 ± 0.16 vs. 1.69 ± 0.37, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%, P < 0.05) and depressed cold vasoconstriction (0.20 ± 0.02 vs. 0.39 ± 0.16%.

Conclusions: This study shows that such autonomic regulation indices as Valsalva index, blood pressure dynamics in the tilt test, cold-stress vasomotor reactivity, and BPV are important for prognosis of hypertension course.