Annotation. Purpose: to examine the state of hemodynamics, blood oxygenation levels in girls with hypotensive type neurodystonia in a dosed physical load. Material: The study involved 59 women with hypotensive type neurodystonia aged 18-19 years and 14 healthy women the same age. Results: It was found that the girls on the background of low systolic blood pressure observed early hemodynamic response from the very first steps (25-50 W) bicycle stress test in the form of increased heart rate, stroke volume, pulse pressure. At the height of the stress test in 76.27 % of girls showed a reduction in blood oxygenation indices and lengthening of the period of recovery. Conclusions: The dose of girls in physical activity with hypotension, place high demands on the cardiovascular system, the restructuring of which is accompanied by inadequate oxygen supply systems in operation, adjustment disorder, low capacity for work that requires a non-drug methods of rehabilitation in the form of regular dose of physical activity, breathing exercises .
Introduction. Some patients with stage 1 arterial hypertension often have symptoms originating from various anatomic and functional locations in the absence of organic changes associated with manifestations of psychosomatic autonomic dysfunction. Among the manifestations, patients have "respiratory", cardiovascular, abdominal symptoms, as well as the signs of anxiety-depressive syndrome. These signs indicate the presence of comorbid psychosomatic disorders in the patient, which can affect the course of hypertension and the nature of the treatment. Materials and methods. The screening was carried out in 125 patients with stage 1 AH. Hyperventilating syndrome was detected in 46.40% of them (n = 58) according to the Nijmegen questionnaire; these patients were included in the experimental group. At the same time, standard indicators of hemodynamics, state of anxiety as an additional marker of psychovegetative dysfunctions according to the Spielberger scale were evaluated. The control group consisted of 24 patients with stage 1 AH without signs of hyperventilating syndrome. By randomization, all patients of the experimental group were divided into 4 groups depending on the treatment: patients from 1st and 2nd group received perindopril and amlessa; 3rd and 4th group – medication in combination with systematic diaphragmatic breathing. The latter provides an anti-stressor effect, normalizes the breathing pattern, eliminates the consequences of hypocapnia and possibly reduces the effect of bradykinin on bronchial tone after taking ACE inhibitors. Results and discussion. A correlation was found (r = 0.72; p ˂ 0.05) between the severity of hyperventilating syndrome (41.63 ± 0.82) points and indicators of total peripheral vascular resistance (1476.13 ± 42.39) dyn•s•cm-5. The latter was significantly higher than the results obtained in the control group of patients – (1374.62 ± 36.11) dyn•s•cm-5 (р ˂ 0.05). At the same time, the signs of state anxiety comprised (42.96 ± 2.05) points vs. the result in the control group (22.36 ± 1.33) points (р ˂ 0.05). The evaluation of the results of the treatment after 2–3 months revealed a significant advantage of the combined effect of medications and systematic diaphragmatic breathing, which reduced hyperventilation in the 3rd and 4th groups by 12.92% and 15.37% (р ˂ 0.05); state anxiety by 16.73% and 20.31% (р ˂ 0.05), respectively, which was not significant in groups 1–2. In addition, diaphragmatic breathing increased the effect of amlessa. When treating patients with stage 1 hypertensive disease it is recommended to search for the signs of hyperventilating syndrome and prescribe combined therapy which includes diaphragmatic breathing and hypotensive medications.
The aim of the work was to study the psycho-vegetative state of students using standardized questionnaires. Materials and methods of research. The study involved students of 18–20 y/o, I–II course of the medical university. According to the results of screening of 448 students, we used a standardized questionnaire by OM Vein. There were 82 people with signs of autonomic dysfunction, which comprised the main study group. To assess the state of autonomic balance, we used cardiointervalography; to verify the hyperventilation syndrome, we used the Nijmegen questionnaire; to assess the psycho-emotional state and anxiety, we used the State-Trait Anxiety Inventory. Results of the research. Among 82 students with signs of autonomic dysfunction, the average score by the Vein scale was 36.12 ± 4.26 points (p ˂ 0.001) vs. 15 points denoting the norm. Subjective symptoms identified by the Vein scale closely correlated with the results of the Nijmegen questionnaire. A positive indicator of the latter – 36.24 ± 1.26 points – was observed in 71.95 % of people, which indicated the presence of hyperventilation syndrome in this group of students. The rest of the students in the main group had a negative result (less than 23 points), although according to the Vein scale, they had signs of autonomic dysfunction, which could indicate a certain premorbid condition. According to the State-Trait Anxiety Inventory, among the 82 people surveyed, students with signs of personal anxiety scored the most points, which were accompanied by emotional "explosions" (56.1 %), neurotic conflicts (35.37 %), feelings of insecurity (46.34 %) and anxiety (37.8 %), etc. We found an association between signs of anxiety and hyperventilation syndrome (r = 0.76). According to the results of the assessment, against the background of anxiety and neurotic symptoms and manifestations of hyperventilation syndrome, the results of the survey revealed signs of somatoform autonomic dysfunction in a significant proportion of students (71.95 %) of the main group, including complaints of respiratory, circulatory and gastrointestinal nature. The lack of isolated psychological markers specific to each psychosomatic disorder should also be noted. Thus, the identified signs of autonomic imbalance by the Vein questionnaire were significantly correlated with the manifestations of hyperventilation syndrome, increased anxiety, somatoform abnormalities, which is the evidence of statistical significance and informativeness of the results of the surveys. Conclusions. Screening surveys among students using standardized questionnaires, analysis of heart rate variability allows identifying a risk group with manifestations of psycho-vegetative dysfunction, maladaptation syndrome and recommending the use of certain health measures to improve quality of life, professional activity.
Comorbid conditions in patients with hypertension on the background of occupational hazards create additional problems in the treatment of hypertension. An analysis of working conditions in 76 workers of the Ivano-Frankivsk armature factory who underwent regular medical check-ups regarding first-/second-degree hypertension (the main group) showed that they were exposed to occupational hazards of chemical (acrolein carbon, iron oxide, chromium, fluorine compounds, sulfuric acid) and physical (high temperature, noise, vibration, electromagnetic radiation, dust) nature for a long period of time (from 4 to 11 years). Comorbid conditions were most often observed among the patients of the main group as compared to the patients of the control group (n = 17), who were not exposed to occupational hazards - 82.06% and 73.34% of cases, respectively. In the patients of the main group, chronic bronchitis was detected in 26.56% of cases and coronary artery disease was diagnosed in 25.09% of cases as compared to 8.33% and 18.34% of cases in the control group. At the same time, 38.89% of hypertensive patients of the main group were diagnosed with chronic bronchitis and concomitant coronary artery disease, which were not observed in the patients of the control group. The patients of the main group were more likely to have dyslipidemia, left ventricular hypertrophy, aortic fibrosis, hypertensive retinopathy as compared to the patients of the control group. In the control group, patients with overweight and type 2 diabetes mellitus prevailed. Quality of life assessment using the 36-Item Short Form Health Survey among the patients of the main group revealed a significant decrease in the indicators of physical and vital activity, fulfillment of daily professional duties. In the control group, a worsening emotional state prevailed.
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