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Multilevel analysis of regulatory mechanism disorders as a principle for individual antihypertensive therapy choice in patients with hypertension (Part I). Аssessment of violations in arterial blood pressure regulation system at different levels in patients with hypertension

[Original research]
Lyudmila Yeliseyeva; Natalya Anatolyevna Samorodskaya;

We avaluated the violations in the regulation of arterial blood pressure (ABP) in patients with the hypertonic disease (HD). The study involved 277 patients with HD of II degree at the age of 58.6±6.4 years. ABP regulation was studied at different levels such as integrative, vegetative support, organ, peripheral. The violation of ABP disease regulation mechanisms at the peripheral level is presented by the pathological types of microcirculation; at the organ level – by morphometric shifts and change of high-speed parameters (ΔS change, increase in linear speed of a kidney blood flow); at the vegetative level depending on the indices of vagosympathetic interrelation (IVSI) we defined types of vegetative regulation (sympathicotonic (1.05<IVSI), parasympathetic (IVSI<0.95) and mixed (0.95<IVSI<1.05)); at the integrative level depending on the index of regulatory adaptive status (IRAS): high (60.0<IRAS), mild (IRAS from 31 to 59), low (IRAS<30). Thereby ABP regulation is provided on the basis of hierarchy of integrative, vegetative, organ and peripheral levels. This approach allows to evaluate the contribution of each level of regulation for HD development and to define the most optimal correction approach.

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Keywords: blood pressure, integration for arterial pressure regulation levels


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