Item condition of the autonomic nervous system in patients with hypertension stage II low additional cardiovascular risk depending on the status of smokers

Authors

DOI:

https://doi.org/10.14739/2310-1210.2013.6.20781

Keywords:

arterial hypertension, autonomic nervous system, blood pressure, smoking

Abstract

Beckground. This century is characterized by steady growth in the number of patients who have cardiac pathology combined with other factors, aggravating the disease and prognosis. High prevalence of smoking among young patients with hypertension. Research devoted to the study of influence of risk factors , including smoking, on the structural and geometric and functional changes of the heart is not enough.

Aim. Explore the contribution of modifiable risk factors for smoking in a pathological process of structural and geometrical and functional restructuring infarction in hypertensive patients.


Material and methods. Examined by transthoracic echocardiography 100 patients (30 smokers and 70 non-smokers) with essential hypertension stage II, 53 men and 47 women. Group of patients matched for age, sex, body mass index, level of  fasting glucose, value "office" SBP, DBP, PAP, mean arterial pressure, heart rate.
For data analysis methods of parametric (t-test for dependent and independent variables, ANOVA ANOVA) and nonparametric (Wald-Wolfowitz runs test, Kolmogorov-Smirnov two-sample test, Mann-Whitney U test) statistics. Differences considered statistically significant at a value of p<0,05.

Results. Hypertensive patients who had smoking status, revealed significantly larger left atrial diastolic by 8.1 % (p = 0.014), systolic 10.8% (p = 0.026), the prevalence of thickness PWLVs 6.1% ( p = 0.028), the thickness IVSd 11.6 % (p = 0.004) , the thickness PWLVs 10.7 % (p = 0.034 ) LVMI 12.2% (p = 0.034) and diastolic intramyocardial stresses 13.9 % (p = 0.025 ), lengthening of the period of isometric relaxation by 33.3 % (p = 0.026 ) compared with those in non-smoking hypertensive patients.


Conclusion. Modulatory effect of smoking on the pathological processes of cardiac remodeling in hypertensive patients manifested by an increase in systolic and diastolic dimensions of the left atrium, wall thickness and left ventricular mass, without an extension of the heart cavities, with an increase in diastolic left ventricular intramyocardial stresses.


Restructuring in hypertensive heart under the influence of smoking creates the conditions for changes in diastolic filling of the left ventricle, with a reduction in active relaxation, increase in the contribution of late filling and prolongation of isometric relaxation.

References

Артериальная гипертензия и сердечно-сосудистый риск /

[А.Э. Багрий, О.И. Дядек, О.И. Жаринов и др.]; под ред. Ю.Н. Сиренко, О.И. Жаринова. – К.: Четверта хвиля, 2009. – 384 с.

Bakhru A. Smoking cessation and cardiovascular disease risk factors: results from the Third National Health and Nutrition Examination Survey / A. Bakhru, T.P. Erlinger // PLoS Med. –2005. – Vol. 2. – P. 160.

Niskanen L. Infl ammation, abdominal obesity, and smoking as predictors of hypertension / L. Niskanen, D.E. Laaksonen, Nyyssonen // Hypertension. – 2004. – Vol. 44. – P. 859–865.

Janzon E. Changes in blood pressure and body weight following smoking cessation in women / E. Janzon, B. Hedblad, G. Berglund et al. //J. Intern. Med. – 2004. – Vol. 255. – P. 266–272.

Bazzano L.A. Relationship between cigarette smoking and novel risk factors for cardiovascular disease in the United States / L.A. Bazzano, J. He, P. Muntner et al. //Ann Intern Med. – 2003. – Vol. 138. – P. 891–897.

Bermudez E.A. Relation between markers of systemic vascular inflammation and smoking in women / E.A. Bermudez, N. Rifai, J.E. Buring et al. // Am. J. Cardiol. – 2002. – Vol. 89. – P. 1117–1119.

Sesso H.D. C-reactive protein and the risk of developing hypertension / H.D. Sesso, J.E. Buring, N. Rifai et al. // JAMA. – 2003. – Vol. 290. – P. 2945–2951.

Primatesta P. Association between smoking and blood pressure:evidence from the Health Survey for England / P. Primatesta, E. Falaschetti, S. Gupta et al. // Hypertension. – 2001. – Vol. 37. – Р. 187–193.

Chika O. Cardiac Sympathetic Nervous Activity More Effectively Compared With L-Type Calcium Channel Blocker in Patients with Hypertension / O. Chika, M. Shoichi, I. Akiko et al. // Circulation. – 2011. – Vol. 124. – P. 122–131.

Campisi R. Effects of long-term smoking on myocardial blood flow, coronary vasomotion and vasodilator capacity / R. Campisi, J. Czernin, H. Schoder // Circulation. – 1998. – Vol. 98. – P. 119–125.

Kim J.W. Acute and chronic effects of cigarette smoking on

arterial stiffness / J.W. Kim, C.G. Park, S.J. Hong // Blood Press. – 2005. – Vol. 14. – Р. 80–85.

Raitakari O.T. Cardiovascular risk factors in childhood and

carotid artery intima-media thickness in adulthood / O.T. Raitakari, M. Juonala, M. Kahonen // JAMA. – 2003. – Vol. 290.

– P. 2277–2283.

Howard G. Cigarette smoking and progression of atherosclerosis / G. Howard, L.E. Wagenknecht, G.L. Burke // JAMA. – 1998. – Vol. 279. – P. 119–124.

Whelton P. Primary prevention of hypertension / P. Whelton, J. He, L. Appel // JAMA. –2002. – Vol. 288. – P. 1882–1888.

Руденко О.І. Рекомендації Європейського товариства

кардіологів 2012 року щодо профілактики серцево-судинних захворювань у клінічній практиці / О.І. Руденко, О.І. Рокита // Серце та судини. – 2013. – № 2. –С. 16–25.

Narnkiewicz K. Is smoking a causative factor of hypertension? / K. Narnkiewicz, S.E. Kjeldsen, T. Hedner // Blood Press. – 2005. – Vol. 14. – P. 69–71.

Barutcu I. Acute cigarette smoking-induced hemodynamic

alterations in the common carotid artery / I. Barutcu, A.M. Esen, B. Degirmenci // Circ J. – 2004. – Vol. 64. – P. 1127–1131.

Li H. Vascular abnormalities in asymptomatic, healthy young adult smokers without other major cardiovascular risk factors: the Bogalusa Heart Study / H. Li, S.R. Srinivasan, W. Chen et al. // Am. J. Hypertens. – 2005. – Vol. 18. – P. 319–324.

Sharrett A. Smoking, diabetes, and blood cholesterol differ in their associations with subclinical atherosclerosis: the Multiethnic Study of Atherosclerosis (MESA) / A. Sharrett, J. Ding, M. Criqui // Atherosclerosis. – 2006. – Vol. 186. – P. 441–447.

Oparil S. Pathogenesis of hypertension / S. Oparil, A. Zaman, D. Calhoun // Ann. Intern Med. – 2003. – Vol. 139. – P. 761–776.

How to Cite

1.
Poznanskaya EA, Syvolap VV. Item condition of the autonomic nervous system in patients with hypertension stage II low additional cardiovascular risk depending on the status of smokers. Zaporozhye Medical Journal [Internet]. 2014Jan.29 [cited 2024Oct.16];15(6). Available from: http://zmj.zsmu.edu.ua/article/view/20781

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Original research