EARLY MARKER AND LIMITED FACTORS OF FUCTIONAL STATE IN PATIENTS WITH MYOCARDIAL INFARCTION IN COMBINATION WITH ARTERIAL HYPERTENSION
DOI:
https://doi.org/10.11603/2415-8798.2019.1.9972Keywords:
myocardial infarction, arterial hypertension, cardio-rehabilitation, Charlson comorbidity indexAbstract
Cardiovascular disease remains the most common cause of death throughout the world. According to the Global Burden of Disease, they account for 31.5 % of all deaths and 45 % of deaths from non-communicable diseases, that exceeds twice the mortality rate of cancer, and also exceeds all infectious, maternal, neonatal and nutritional disorders taken together. Over 75 % of all cardiovascular deaths occur in low and middle income countries, and in Ukraine, cardiovascular mortality is 66.7 %.
The aim of the study – to learn the peculiarities of the clinical course of myocardial infarction (MI) with a comorbid pathology occurring on the background of arterial hypertension (AH), to identify the early marker and limiting parameters of the functional parameters of the body and stratification risks to control the effectiveness of the rehabilitation process.
Materials and Methods. 371 patients with a myocardial infarction with a comorbid pathology, which took place during the 90-year period of rehabilitation were studied. The basic functional indicators of the body of the patient with MI and their association with hypertension, as well as clinical markers of reduced exercise tolerance and the Charlson comorbidity index were studied.
Results and Discussion. Interrelations between arterial hypertension and general-clinical and special functional indicators in patients with MI were analyzed. A direct correlation between AH and age was found (r = 0.123; P = 0.018), between hypertension and systolic (r = 0.253; P <0.0001) and diastolic (r = 0.215; P <0.0001) arterial pressure in acute period of the MI, between AH and the comorbidity index (r = 0.133; P = 0.01), the direct correlation between the hypertension and the thickness of the walls of the left ventricle (r1 = 0.173; P1 = 0.003; r2 = 0.149; P2 = 0.003). There was also an inverse correlation between hypertension and the number of lymphocytes (r = -0.197; P = 0.015).
Conclusions. Indicators of systolic and diastolic blood pressure in the acute phase of MI development are highly sensitive markers of hemodynamic, morphological and functional changes in patients with MI with hypertension and adequately reflect the general functional state of the patient, and therefore should be constantly monitored during the rehabilitation process. The number of peripheral blood lymphocytes and the Charlson comorbidity index are important additional marker and limiting indicators for rehabilitation in patients with MI with AH.
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