The influence of smoking on the functional state of microcirculation according to laser doppler flowmetry and clinical anamnestic data of patients with arterial hypertension

Abstract

Background. Detailed study of the functional state of microcirculation in combination of arterial hypertension and tobacco smoking, as the most common and prognostically important risk factors for atherogenesis, will not only clarify pathogenetic effect of tobacco smoke on the terminal vascular bed, but also outline directions of active counteraction to it.Purpose. To study the effect of TS on the functional state of SM using laser Doppler flowmetry in patients with AH.Methods. 185 patients with stage 1,2 AH involved in the study were divided into 2 equivalent groups according to main clinical and laboratory data: group 1 – non-smokers (n = 134, mean age was 57.0 [50.0; 60.0]), group 2 – patients who smoke 1–1.5 packs of cigarettes per day (n = 51, mean age was 54.0 [48.0; 58.0]). Patients were prescribed short-acting antihypertensives drugs, which were used whenever required 5 days before the study. SM was investigated by laser Doppler flowmetry using occlusion test and amplitude-frequency spectrum analysis of hemoperfusion fluctuations.Results. Obtained data showed negative acute effect of ingredients of tobacco smoke on almost all structural elements of microhemocirculation. Revealed deviations are characterized by constriction of precapillary segment of microvascular bed with increase in myogenic tone and equal 3.1 units [2.6; 4.1] versus 2.3 units [1.7; 3.4] in the alternative group (p = 0.007), decrease in capillary blood flow from 4.5 units [3.5; 5.8] compared with the group of non-smokers – 5.2 units [4.0; 7.3] (p = 0.041), statistically significant intensification of arteriolar-venular blood flow with formation of venous congestion, limitation of dilated reserve of microcirculation.Conclusion. Tobacco smoking leads to significant microcirculation disorders that are projected onto changes in terminal vascular bed, inherent with AH, which significantly reduces the functional state of microcirculation, limits its reserve potential and promotes the development of tissue ischemia.

Hypertension: smoking or quit. Clinical difficulties

“…Алгоритмы антитабачного консультирования сформулированы специалистами ФГБУ "НМИЦ ТПМ" Минздрава России, опубликованы и доступны в широкой печати [21,22]. яние компонентов табачного дыма на все элементы МЦ с преобладанием констрикции прекапиллярного сегмента микроциркуляторного русла (МЦР), увеличением миогенного тонуса, снижением капиллярного кровотока, статистически значимой интенсификацией артериоло-венулярного кровотока с формированием венозного полнокровия, ограничением дилатационного резерва МЦ в сравнении с некурившими [34]. Нарушения гемореологии за счет дисфункции эндотелия и агрегации тромбоцитов, увеличения количества эритроцитов в периферической крови, активации перекисного окисления белков и липидов, повышения продукции эндотелина-1, натрийуретического пептида С у курящих в сравнении с никогда не курившими описаны в обзоре Ройтмана Е. В. и др.…”