Features of the relationship between blood pressure and endothelial vasomotor function of the initial manifestations of chronic brain ischemia patients

Abstract

Introduction. Cerebrovascular pathology in all its manifestations (acute ischemic stroke and chronic cerebral ischemia) leads to significant mortality and disability in the population in our country. Arterial hypertension (AH) is one of the main factors of cardiovascular risk of chronic cerebral ischemia (ChCI). We carried out a study whose purpose was to assess the state density and the nature of relationships between indicators AP monitoring (DAPM) and biochemical indices of endothelial vasomotor function in patients with initial manifestations of ChCI.
 Material and methods. We examined 116 patients with initial manifestations of ChCI. All patients underwent general-clinical, clinical and neurological, neuroimaging, clinical and laboratory examination, including the determination of biochemical markers of vasomotor endothelial dysfunction (endothelin-1 (ET-1) and nitrite) and compression test to assess flow-mediated dilation (FMD).
 Results and its discussion. Percentage (FMD obtained during cuff trials statistically significantly correlated with mean PAT day (r = -0,306, p = 0,002) and an average PAP night (r = -0,327, p = 0,001). Tight linkage was observed between the level of ET-1 and indicators of blood pressure variability, thus mainly at night (SBP, DBP, ABP, PBP). The level of nitrite was mainly associated with blood pressure load index. A sufficiently high density of association (by Cramer's V=0,419-0,566) points to the clinical significance of the relative risk of rejection nitrite levels beyond the norms (the development of endothelial dysfunction) by increasing the load systolic and diastolic blood pressure and systolic blood pressure during the day at night.
 Conclusions. It was found that the increase in PAP in active and passive during the day has been associated with the development of vasomotor ED. It was found that increased levels of ET-1 was accompanied by an increase in the variability of systolic blood pressure during the day and at night, diastolic blood pressure, SBP and DBP at night. There was a trend to an increase in systolic blood pressure load due to lower levels of nitrite. Sufficient density of associative links point to the trend towards the development of vasomotor ED with increasing load systolic blood pressure during the day and at night.