RESUMEN
AIM: To study relationships of 24-hour heart rate (HR) profile with involvement of the heart and kidney in women with arterial hypertension (AH). MATERIAL: We examined women (n=273) aged 40-70 years with essential 2-3 degree AH. METHODS: Blood pressure (BP) measurements (8 times in a week), electrocardiography, echocardiography, ambulatory BP monitoring, complex laboratory diagnostics. RESULTS: Less than 10% HR lowering was registered in 22.7% of patients. Compared with the group with normal HR profile this group was characterized by high levels of clinical systolic and diastolic BP (SBP, DBP), mean 24-hour BP, nocturnal BP, SBP time index, as well as low levels of 24-hour SBP, HR, and HR variability. Same group had also significantly greater left atrial dimensions, and higher values of NT-proBNP and total risk according to SCORE (Systematic Coronary Risk Estimation). Correlation analysis revealed significant reverse association between 24-hour HR index which reflected circadian character of cardiac rhythm, left atrial dimension (r=-0.212) and NT-proBNP (r=-0.346). Flat HR profile was not statistically significant for detection of cardiac pathology (odds ratio 1.19; 95% confidence interval from 0.67 to 2.14). CONCLUSION: Insufficient nocturnal HR lowering in women with AH was not associated with significant changes of the myocardium and kidney and clear cat links with dyslipidemia, obesity, and smoking.
Asunto(s)
Electrocardiografía Ambulatoria/métodos , Atrios Cardíacos , Frecuencia Cardíaca , Hipertensión , Pruebas de Función Renal/métodos , Adulto , Anciano , Ritmo Circadiano , Ecocardiografía/métodos , Femenino , Atrios Cardíacos/patología , Atrios Cardíacos/fisiopatología , Humanos , Hipertensión/sangre , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Persona de Mediana Edad , Péptido Natriurético Encefálico/sangre , Puntuaciones en la Disfunción de Órganos , Tamaño de los Órganos , Fragmentos de Péptidos/sangre , Pronóstico , Medición de Riesgo , Factores de RiesgoAsunto(s)
Presión Sanguínea , Muerte Súbita Cardíaca , Electrocardiografía , Hipertensión , Anciano , Determinación de la Presión Sanguínea , Muerte Súbita Cardíaca/epidemiología , Muerte Súbita Cardíaca/etiología , Ecocardiografía , Estonia/epidemiología , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Persona de Mediana Edad , Pronóstico , Estudios Prospectivos , Factores de RiesgoRESUMEN
Aim of the study was to assess dynamics of prevalence of arterial hypertension (AH) and main cardiovascular risk factors (RF) in a women population of Tallin during 10 years of follow up. In 2008-2009 we repeated measurements of arterial pressure (AP), electrocardiographic, echocardiographic, and complex laboratory examinations in 314 participants of epidemiological study undertaken in 1999-2000. Most prevalent RF was hypercholesterolemia. Rate of its detection substantially rose from 69.1 to 81.2%. Number of subjects who continuously took cholesterol lowering drugs and had target levels of lipid profile was sporadic. Prevalence of hypertriglyceridemia, obesity, and diabetes mellitus insignificantly increased. Only prevalence of smoking had tendency to reduction. AH was found in 28.7 and 44.6% of women in 1999-2000 and 2009, respectively. Obesity and hypercholesterolemia contributed significantly to development of new cases of AH. Among subjects with AH 25% of women received antihypertensive therapy and achieved target AP levels--3 times more than in 2000. Thus prevalence of AH and other main RF in female population of Tallin increased during 10 years follow-up. However control of AP in patients with AH notably improved.
Asunto(s)
Enfermedades Cardiovasculares/prevención & control , Hipercolesterolemia/complicaciones , Hipercolesterolemia/epidemiología , Hipertensión , Monitoreo Fisiológico/tendencias , Calidad de la Atención de Salud/tendencias , Adulto , Antihipertensivos/uso terapéutico , Enfermedades Cardiovasculares/epidemiología , Enfermedades Cardiovasculares/etiología , Enfermedades Cardiovasculares/fisiopatología , Diabetes Mellitus Tipo 2/complicaciones , Diabetes Mellitus Tipo 2/epidemiología , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/fisiopatología , Estonia/epidemiología , Femenino , Humanos , Hipercolesterolemia/tratamiento farmacológico , Hipercolesterolemia/metabolismo , Hipercolesterolemia/fisiopatología , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertensión/tratamiento farmacológico , Hipertensión/epidemiología , Hipertensión/fisiopatología , Hipolipemiantes/uso terapéutico , Estilo de Vida , Persona de Mediana Edad , Obesidad/complicaciones , Obesidad/metabolismo , Obesidad/fisiopatología , Prevalencia , Estudios Retrospectivos , Factores de Riesgo , Fumar/epidemiologíaRESUMEN
Aim of the study was to investigate relationship between arterial hypertension (AH), left ventricular myocardial mass (LVMM), and levels of N-terminal pro-B type natriuretic peptide (pro-NT BNP) in a population of women inhabitants of Tallinn aged 56-65 years. Of 163 women aged 50-59 years who had participated in epidemiological study in 2000 in 132 measurement of arterial pressure (AP), electrocardiography, echocardiography, complex laboratory diagnostics including determination of pro-NT BNP were repeated in 2007. Most frequent risk factor was AH which was detected in 56.1% of cases. In women with normal AP normal LVMM was noted in 81.1% of cases, while in women with elevated AP normal LVMM was significantly less frequent (28.4%). Only in 5 of 28 women with elevated pro-NT BNP deviations of systolic-diastolic function were observed. Elevated levels of pro-NT BNP were found with almost equal rates among patients with normal and increased LWMM (in 9.1 and 8.3% of cases, respectively). Thus increase of content of pro-NT BNP is of limited significance for diagnosis of left ventricular hypertrophy in women aged 56-65 years without clinical signs of disease.
Asunto(s)
Ecocardiografía/métodos , Hipertensión/complicaciones , Hipertrofia Ventricular Izquierda/diagnóstico por imagen , Péptido Natriurético Encefálico/sangre , Fragmentos de Péptidos/sangre , Anciano , Progresión de la Enfermedad , Femenino , Estudios de Seguimiento , Humanos , Hipertensión/sangre , Hipertensión/diagnóstico por imagen , Hipertrofia Ventricular Izquierda/sangre , Hipertrofia Ventricular Izquierda/etiología , Persona de Mediana Edad , Pronóstico , Precursores de Proteínas , Estudios Retrospectivos , Función Ventricular Izquierda/fisiologíaRESUMEN
AIM: To elucidate relation between prolongation of corrected maximal QT intervals and QT dispersion (QTcmax, QTcD) and presence and severity of arterial hypertension, as well as other factors determining high cardiovascular risk in female population of Tallinn aged 56 - 66 years. MATERIAL AND METHODS: A sample of female citizens of Tallinn (n=123, age 56 - 65 years) were subjected to standard examination including blood pressure measurement, electrocardiography, echocardiography, and laboratory tests. RESULTS: Presence of prolonged QTcmax and/or QTcD were associated with elevation of pulse pressure, which reflected strain and elasticity of the aorta, as well as with presence of left ventricular hypertrophy, especially concentric variant of changes of left ventricular geometry. Participants with prolonged QTcmax and/or QTcD had higher total 10 year risk of cardiovascular morbidity and mortality.
Asunto(s)
Enfermedades Cardiovasculares/epidemiología , Electrocardiografía , Enfermedades Cardiovasculares/fisiopatología , Estonia/epidemiología , Femenino , Humanos , Persona de Mediana Edad , Morbilidad/tendencias , Medición de Riesgo , Factores de Riesgo , Tasa de Supervivencia/tendenciasRESUMEN
Echocardiography was performed in 325 men and 398 women in the framework of a population survey of inhabitants of Tallinn aged 35 to 59 years in 1999-2001. Left ventricular geometry was analyzed according to generally recognized four types. Prevalence of concentric hypertrophy was similar in men and women (7.7% and 9.1%, respectively). In all age groups prevalence of eccentric hypertrophy in women was 4-10-fold higher than in men (33.3 and 4.9%, respectively). Concentric remodeling was also more frequent in women than in men (9.5 and 5.5%; respectively, p<0.05). Regardless of sex and age, concentric hypertrophy was never found in participants with normal blood pressure. In hypertensives there was a tendency for age-related increase of prevalence of concentric hypertrophy: the latter was higher in women than in men (39.1% and 25.5%; respectively, p<0.05). In examinees with body mass index (BMI) <30 this type was rare. In obese persons its frequency increased with age in both sexes reaching 26.5% in men and 21.2% in women (p<0.05). Prevalence of eccentric hypertrophy in men increased with age, especially in the presence of hypertension and obesity. In men the prevalence of concentric remodeling was not related to BMI; it was significantly more often found in older age groups and in hypertensives. In women the prevalence of eccentric hypertrophy and concentric remodeling was not related to age, hypertension and BMI. The frequency of normal geometry decreased with age in both sexes.
Asunto(s)
Hipertrofia Ventricular Izquierda/patología , Hipertrofia Ventricular Izquierda/fisiopatología , Remodelación Ventricular , Adulto , Factores de Edad , Presión Sanguínea/fisiología , Peso Corporal/fisiología , Estonia/epidemiología , Femenino , Ventrículos Cardíacos/diagnóstico por imagen , Ventrículos Cardíacos/patología , Ventrículos Cardíacos/fisiopatología , Humanos , Hipertrofia Ventricular Izquierda/epidemiología , Masculino , Persona de Mediana Edad , Obesidad/patología , Obesidad/fisiopatología , Vigilancia de la Población , Factores Sexuales , UltrasonografíaRESUMEN
This paper gives an overview of a research, which is focused on the development of the convenient device for continuous non-invasive monitoring of arterial blood pressure. The blood pressure estimation method is based on a presumption that there is a singular relationship between the pulse wave propagation time in arterial system and blood pressure. The parameter used in this study is pulse wave transit time (PWTT). The measurement of PWTT involves the registration of two time markers, one of which is based on ECG R peak detection and another on the detection of pulse wave in peripheral arteries. The reliability of beat to beat systolic blood pressure calculation during physical exercise was the main focus for the current paper. Sixty-one subjects (healthy and hypertensive) were studied with the bicycle exercise test. As a result of current study it is shown that with the correct personal calibration it is possible to estimate the beat to beat systolic arterial blood pressure during the exercise with comparable accuracy to conventional noninvasive methods.
RESUMEN
AIM: To assess relationship between QT dispersion, hypertension, and different variants of left ventricular geometry (concentric or eccentric hypertrophy, concentric remodeling). MATERIAL AND METHODS: Blood pressure measurement, electro- and echocardiography were used in the study of a random sample of Tallinn population (321 men and 396 women) aged 35-59 years. Corrected QT dispersion (QT(c)D) equal to or exceeding 70 ms was considered increased. RESULTS: Increase of QT(c)D was associated with left ventricular hypertrophy, especially with its concentric variant. QT(c)D prolongation was significantly more frequent in subjects with hypertension.
Asunto(s)
Ventrículos Cardíacos/fisiopatología , Hipertensión/fisiopatología , Hipertrofia Ventricular Izquierda/fisiopatología , Adulto , Ecocardiografía , Electrocardiografía , Femenino , Humanos , Hipertensión/complicaciones , Hipertensión/diagnóstico , Hipertrofia Ventricular Izquierda/diagnóstico , Hipertrofia Ventricular Izquierda/etiología , Masculino , Persona de Mediana Edad , Muestreo , Remodelación Ventricular/fisiologíaRESUMEN
In a framework of a population study in Tallinn triple blood pressure measurements, electro- and echocardiography were carried out in 398 women (82.6% of all participants) aged 35-59. Left ventricular hypertrophy (left ventricular mass >or=198 g, left ventricular mass/height ratio >or=121 g/m, left ventricular mass/body surface area ratio >or=120 g/m2) was found in 43% of these women. Distribution of variants of left ventricular remodeling was as follows: concentric hypertrophy - 9.1%, eccentric hypertrophy - 33.9%, concentric remodeling - 9.5%, normal myocardial geometry - 47.5%. Only concentric hypertrophy was associated with elevated blood pressure and obesity frequency of both of which increased with age.