FEATURES OF DIURNAL BLOOD PRESSURE PROFILE, ARTERIAL STIFFNESS AND CENTRAL AORTIC PRESSURE IN PATIENTS WITH ARTERIAL HYPERTENSION AND PREDIABETES

Aim. To assess the features of diurnal blood pressure profile, arterial stiffness and central aortic pressure in patients with arterial hypertension (AH) and prediabetes.

Materials and methods. The study included 118 patients with AH, 38 without prediabetes, 80 with prediabetes, 48 of them patients with impaired fasting glucose and 32 patients with impaired glucose tolerance. Prediabetes was determined by the results of an oral glucose tolerance test. All patients underwent 24-hour blood pressure monitoring the main parameters of arterial stiffness and central aortic pressure were determined using the BPLab Vasotens complex of OOO «Petr Telegin» (Russia).

Results. The obtained data showed that in patients with hypertension and prediabetes there were recorded increased levels of systolic and pulsatile blood pressure in the brachial artery and aorta, a more pronounced "pressure load" was detected compared to patients without prediabetes. At night, the level of diastolic blood pressure in the brachial artery and aorta, the diastolic pressure time index was higher than in patients with AH without prediabetes. Pathological type of the "non-dipper" curve was detected 2.5 times more often in patients with AH and prediabetes. Moreover, the pulse wave velocity, the augmentation index in the brachial artery and aorta characterizing the stiffness of the vessel wall were significantly higher in hypertensive patients with prediabetes.

Conclusion. Thereby, in patients with AH in combination with prediabetes, unlike patients without prediabetes, there were more pronounced changes in the parameters of the diurnal blood pressure profile, arterial stiffness and central aortic pressure including the pulse wave velocity, the augmentation index and pulsatile pressure which are known to be sensitive indicators of target organ damage and are associated with an increased risk of developing cardiovascular and cerebrovascular complications.