DETERMINATION OF CENTRAL AORTIC PRESSURE AS AN INDICATOR OF “FALSE” HYPERTENSION EXCLUSION IN LOCOMOTIVE WORKERS
Topicality. The profession of locomotive workers causes increased requirements to health in connection with specific characteristics of the job, namely: conducting of a fast-moving object; exclusive responsibility for the life of passengers. Central aortic pressure is a better predictor of cardiovascular disease than the corresponding brachial blood pressure, as it allows to define more precisely the degree of pressure on left ventricular wall and arteries.
Objective. Determination of the clinical importance and comparability of indicators of daily monitoring of arterial pressure and the central aortal pressure with locomotive crews.
Methods. The test group embraced a total 50 workers of locomotive crews with hypertension grade 1, 37.8 years old median age. The control group included 20 locomotive workers 39,8 years old median age with a normotoniya. Ambulatory blood pressure monitoring was conducted in the outpatient unit BPLab («Peter Telegin", Russia). When interpreting the research results, average systolic, diastolic, mean hemodynamic blood pressure and pulse for a day were analyzed. Structural and functional properties of the vascular wall were evaluated on the basis of ambulatory blood pressure device BPLab with additional software Vasotens.
Results. Blood pressure monitoring (Bpm) showed arterial hypertension (AH) in 100% of the surveyed patients; of these, AH was found stable in 54.5% and labile in 45.4%. Arterial pressure average figures were 140 and 82 mm of in the daytime and 132 and 73 at night. For 64% of patients central aortic pressure (CAP) was 127 and 87 at the daytime and 120 and 72 at night. For 36% of patients revealed normotoniya when monitored for CAP (111 and 69 at the daytime and 102 and 62 mm at night). The augmentation index (AI) was as varied and made 17% at the daytime and 17% at night, with patients with 1 degree AH. At the same time with patient with normal indicators of CAP the AI was -4 and -2. No reliable difference in the pulse wave velocity (PWV) in these groups was revealed (the average PWV was 8.7 mm\s at the daytime and 8.01 mm / s at night).
The control group of patients revealed normal indicators arterial pressure and CAP. The AI was marked negatively. PWV was normal compared to that of the test group and was on the average 6.7 mm/s at the daytime and 6.6. mm/s at night.
Conclusion. The daily profile central aortic pressure and augmentation index can serve as indicators for “false” arterial hypertension exclusion. The “false” arterial hypertension was accompanied with increase pulse wave velocity, in comparison with that of control group which can be considered as a predictor of arterial hypertension development.