Some Questions Concerning Non Invasive Diagnosis In Arterial Hypertesion

摘要

This study was designated to find and to characterize similarities andf differencies between two groups of patiens. One group were patients with established arterial hypertension / AH / and the second one were patients with new diagnosis of AH or who have so called high normal blood pressure. The main goal of the study was to show that the groups are similar in important parameters, which may be of clinical importance and to find which of the non invasive examinations, with exception of classical blood pressure / BP / measurements, may still play the important role in setting the diagnosis of AH in early stage of the disease.Following methods and measurements were used due to obtain necessary parameters – arterial blood pressure measurement, echocardiographic examination to obtain values as left ventricular diameter in systole and diastole, interventricular septum and posterior wall thickness in systole and diastole, ejection fraction - Teichholz, interventricular septum and posterior wall excursions, left atrial diameter, measuremnt of speed of aortic ejection, E/A index, isovolumic relaxation time, carotid myointimal thickening, carotid pulse velocity, time to peak of carotid upstroke and ambulatory blood pressure and electrocardiogram monitoring, measurement of blood pressure reaction on exercise stress testing and in recovery period post exercise and double product. Introduction Essential arterial hypertension / AH / is the main risk factor in the development of aterosclerosis. At the present time we have possibility to diagnose AH at the early stage of disease.It is known that AH is as the aterosclerosis the self perpetuating process. So, when we have qualified suspicion on this disease we should immediately start with antihypertensive therapy.In this work is shown that between patients with new diagnosis of AH or who have so called normal high blood pressure and patients with defined diagnosis of AH exist great similarity in observed parameters, especially in blood pressure reaction on exercise and in the development of blood pressure in recovery phase post exercise. Thirtysix patients, otherwise healthy as to the cardiovascular system, with less or more elevated blood pressure at admission or at history and onehundredsix patients with diagnosis of hypertensive arterial disease were studied. Under normal conditions the patients from the first group would be recommnended only to change and improve their lifesytel, as to the increase their physical activity, sufficient relaxation, stress reduction, body weight reduction, salt intake lowering etc. And they are summoned to checks of their BP after certain time periods. But we should be more active in this situation.It was decided to put these patients through all of these above mentioned examinations inclusive exercise stress testing in order to find certain differencies or similarities on noninvasive examination between both groups. Methods Following parameters were measured – arterial blood pressure, echocardiographic values as left ventricular diameter in systole and diastole, interventricular septum and posterior wall thickness in systole and diastole, ejection fraction - Teichholz, interventricular septum and posterior wall excursions, left atrial diameter, speed of aortic ejection, E/A index, isovolumic relaxation time, carotid myointimal thickening, carotid pulse velocity, time to peak of carotid upstroke and ambulatory blood pressure and electrocardiogram monitoring, blood pressure reaction in single stages of exercise stress testing and in single stages of recovery period post exercise, double product.The results were analysed by means of Student's t-test and the median and frequency rates were determined for different graphs. Results Baseline characteristics of the patients of both groups are presented in Table 1. Group 1 are patients with chronic AH, group 2 are patients with new diagnosis of AH. Light but statistically significant difference between the groups wa