[Cerebrovascular reactivity in patients with rheumatoid arthritis concurrent with and without hypertension].

Abstract:

AIM:To compare cerebrovascular reactivity (CVR) in patients with rheumatoid arthritis (RA) concurrent with essential hypertension (Group 1) and in those with RA and normal blood pressure (BP) (Group 2). SUBJECTS AND METHODS:During the study of Groups 1 (n = 37) and 2 (n = 12), the investigators estimated the prevalence of traditional cardiovascular risk factors, performed 24-hour BP monitoring, investigated CVR by transcranial Doppler (TCD) of the middle cerebral arteries (MCA) by hyperoxic and hypercapnic tests, and endothelium-dependent vasodilation (EDV) and endothelium-independent vasodilation of the brachial artery. The groups were matched for gender, age, RA activity and stage, and antirheumatic therapy volume. RESULTS:According to the results of MCA TCD, the hyperoxic test recorded impaired CVR in 34 (92%) and 10 (83%) patients in Group 1 and 2, respectively; the hypercapnic test revealed this condition in 19 (51%) and 6 (50%) patients in these groups, respectively. The hyperoxic test most commonly showed an insufficient decrease in MCA linear blood flow velocities (LBFV) in 31 (84%) and 8 (66%) patients in Groups 1 and 2, respectively; the hypercapnic test did an excessive increase in MCA LBFV in 12 (32%) and 4 (33%) patients, respectively. There was a high rate of impaired EDV in 32 (86%) and 9 (75%) patients in Groups 1 and 2, respectively. CONCLUSION:According to the results of MCA TCD, there were high and similar rates of impaired CVR in patients with RA concurrent with and without essential hypertension during the hyperoxic and hypercapnic tests. :Цель исследования. Сравнить реактивность сосудов головного мозга (РСГМ) у больных ревматоидным артритом (РА) в сочетании с эссенциальной артериальной гипертонией - АГ (1-я группа) и на фоне нормального артериального давления - АД (2-я группа). Материалы и методы. В рамках исследования у 37 больных 1-й и у 12 больных 2-й групп оценивали распространенность традиционных факторов риска развития сердечно-сосудистых заболеваний, выполняли суточное мониторирование АД, изучали РСГМ с помощью транскраниальной допплерографии (ТКД) средних мозговых артерий (СМА) с проведением гипероксической и гиперкапнической проб, зависимую от эндотелия (ЗЭВД) и независимую от эндотелия вазодилатацию (НЭВД) плечевой артерии. Группы сопоставимы по полу, возрасту, степени активности и стадии РА, объему противоревматической терапии. Результаты. По результатам ТКД СМА нарушение РСГМ регистрировали в гипероксической пробе у 34 (92%) больных 1-й группы и 10 (83%) больных 2-й группы; в гиперкапнической пробе - у 19 (51%) и 6 (50%) больных соответственно. Наиболее часто в гипероксической пробе наблюдали недостаточное снижение линейных скоростей кровотока (ЛСК) в СМА у 31 (84%) больных 1-й группы и 8 (66%) больных 2-й группы, в гиперкапнической пробе - чрезмерное увеличение ЛСК в СМА у 12 (32%) и 4 (33%) больных соответственно. Установлена высокая частота нарушения ЭЗВД у 32 (86%) больных 1-й группы и у 9 (75%) больных 2-й группы. Заключение. По результатам ТКД СМА у больных РА в сочетании с АГ и без нее выявлена высокая и сопоставимая частота нарушения РСГМ при проведении гипероксической и гиперкапнической проб.

journal_name

Ter Arkh

journal_title

Terapevticheskii arkhiv

authors

Rebrova NV,Anisimova EA,Sarkisova OL,Mordovin VF,Karpov RS,Ripp TM,Trifonova TG,Bogomolova II

doi

10.17116/terarkh201587424-29

subject

Has Abstract

pub_date

2015-01-01 00:00:00

pages

24-29

issue

4

eissn

0040-3660

issn

2309-5342

journal_volume

87

pub_type

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