ARTERIAL HYPERTENSION IN PATIENTS WITH ATHEROSCLEROTIC LESIONS AND PATHOLOGICAL TORTUOSITY OF THE CAROTID ARTERIES BEFORE AND AFTER SURGICAL CORRECTION OF CAROTID STENOSES
DOI:
https://doi.org/10.11603/1811-2471.2020.v.i2.11321Keywords:
arterial hypertension, atherosclerosis, carotid stenosis, pathological tortuosity, carotid endarterectomyAbstract
One of the leading causes of ischemic stroke in patients with hypertension (AH), second only to atherosclerosis (AS), is pathological tortuosity of the carotid arteries (CA).
The aim – to study the features of the dynamics of blood pressure (BP) in patients with hypertension in combination with AS or tortuosity of the CA before and after carotid endarterectomy (CE).
Materials and Methods. 104 patients with hypertension and carotid stenoses were selected for CE. Patients were divided into two groups: 76 patients with AS of the CA (group 1), and 28 patients with tortuosity of the CA, that did not combine with AS and (or) with fibromuscular dysplasia (group 2). Patients underwent ambulatory BP monitoring (ABPM) for 2 days and 3 months after CE. The age ranged from 36 to 70 years.
Results. Prior to surgery, patients in group 1 had a significantly higher level of mean systolic BP per 24 hours (p<0.001), per day (p<0.001), per night (p<0.0001), mean diastolic BP per 24 hours (p<0.001), per day (p<0.01), at night (p<0.001) and significantly higher values of daytime variability of systolic BP (p<0.02) and diastolic BP (p<0.03). The level of heart rate was higher than the normative values in both groups, and significantly higher in group 1.
After the operation, patients in group 1 had a significant positive dynamics of all indicators of ABPM. In patients of group 2 recorded significant positive dynamics of only the average night diastolic BP (p<0.01), and did not observe significant changes in other indicators of systolic BP and diastolic BP. Significantly positive dynamics of BP variability was observed in patients with AS of the CA.
Conclusions. In patients with AS of the CA, surgical treatment is associated with a steady decrease in blood pressure, in contrast to patients with tortuosity of the CA.
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