AUTONOMIC NERVOUS SYSTEM ADAPTATIONS IN PATIENTS WITH ARTERIAL HYPERTENSION AND THEIR CORRELATIONS WITH CLINICAL AND ECHOCARDIOGRAPHIC PARAMETERS

Methods. 152 patients (age 59.5 [55,5-63] years, 104 men, 48 women) with arterial hypertension were included in the study. All patients underwent echocardiography, the assessment of intima-media thickness, cardiointervalography at rest and during active orthostatic test (AOT) with the further assessment of adaptation with the ORTO expert diagnostic system. All patients were divided into three groups according to the obtained results: Group 1 consisted of patients with high adaptation (n = 24), Group 2 patients with altered adaptation mechanisms (n = 66), Group 3 patients with poor adaptation (n = 62).

Results. A 9.5% increase in the intima-media thickness has been found in Group 3 compared to the other study groups (p = 0.0075). Very low frequency power in Group 3 was higher than in Group 1 (p = 0.02). The Et / At ratio in Group 2 and Group 3 was higher compared with Group 1 (p = 0.003). Univariate logistic regression analysis reported the probability of failure of the adaptation mechanisms with increased IMT> 0.9 mm (p = 0.01), Et / At ratio > 1.4 (p = 0.0004) and Et > 60 cm / sec (p = 0.009). Multiple logistic regression reported similar results.

Conclusion. High adaptation was found in 16% of patients with hypertension, stress-altered adaptation mechanisms were observed in 43%, and poor adaptation in 41% of patients. Poor adaptation was associated with increased IMT and predominance of very low frequency in the spectral analysis of heart rate variability as well as with values of the right ventricular diastolic function.

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