24-hour arterial stiffness monitoring in comorbid patients with cardiovascular pathology

Aim. To evaluate 24-hour dynamics of the arterial stiffness main indicators in patients with arterial hypertension associated with metabolic syndrome, coronary heart disease and type 2 diabetes mellitus.

Methods. The study included 54 patients with hypertension, who formed main groups: the first group - 17 patients with hypertension amid the metabolic syndrome, the second - 21 patients with metabolic syndrome and coronary heart disease, the third group - 16 patients with hypertension and type 2 diabetes mellitus. All patients underwent the vascular stiffness parameters study using a multifunctional complex for the 24-hour monitoring and office measurements of blood pressure and vessels condition. At the same time blood pressure, cardiac function and vascular stiffness indicators were examined: PWVao - pulse wave velocity in the aorta (m/s); PWTT - the pulse wave transit time (m/s); Aix - augmentation index (%); Asi - the arterial stiffness index. (mmHg).

Results. When comparing the 24-hour arterial stiffness dynamics indicators, changes were found in all main patients groups compared to the healthy group. Thus, a statistically significant increase in the pulse wave velocity in the aorta (PWVao) in all groups of patients compared with the control group, a decrease in the index of the pulse wave transit time (PWTT) in all main groups of patients and a significant increase in arterial stiffness index (Asi) were found. When assessing the results of arterial stiffness monitoring at night time significantly larger values of the pulse wave velocity in the aorta were observed in patients with the metabolic syndrome and combination of metabolic syndrome and coronary heart disease. The obtained data are indicative of improvement in vascular stiffness indicators at night time in healthy individuals group, as well as maintaining a high degree of the vascular wall stiffness both in the night and in the daytime in a group of examined patients, especially in groups with the metabolic syndrome, and a combination of metabolic syndrome and coronary heart disease.

Conclusion. 24-hour monitoring of vascular stiffness indicators in comorbid patients have revealed variability of the main indicators during the day; such arterial stiffness indicators as the pulse wave transit time, pulse wave velocity in the aorta, the arterial stiffness index, augmentation index can be used to assess early signs of the major arteries remodeling.