Взаимосвязь степени ночного снижения артериального давления и выраженности атеросклероза коронарных артерий у больных гипертонической болезнью

Цель    Целью данного исследования было определить связь между характером ночного снижения АД и ишемической болезнью сердца у пациентов с артериальной гипертензией.
Материал и методы    В исследование было включено 356 больных АГ. Ретроспективно оценивались результаты амбулаторного мониторирования АД, эхокардиографии и коронарной компьютерной томографической ангиографии. На основании данных амбулаторного мониторирования АД пациенты были разделены на две группы: 1) больные с достаточным снижением ночного АД (ДП); 2) пациенты с недостаточным снижением ночного АД (НДП).
Результаты    Среди 356 пациентов 145 были мужчинами (40,7%). Статус курения был выше у больных с НДП (р=0,023). Использование статинов у пациентов с нормальной динамикой АД было выше, чем у пациентов с НДП (p = 0,027). Существенных различий в эхокардиографических данных не было. У 58,6% пациентов без наличия атеросклеротических бляшек наблюдалось снижение ночного АД (p<0,05), однако у 84,4% пациентов с наличием атеросклеротических бляшек, занимающих >50% просвета сосуда, было недостаточное снижение ночного АД (p<0,001).
Вывод    Недостаточное снижение ночного АД может быть связано с усилением атеросклеротического процесса в коронарных артериях, а пациенты с НДП могут иметь повышенную атеросклеротическую нагрузку на коронарные артерии по сравнению с пациентами со снижением ночного АД.

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