Instrumental methods for diagnosis and assessment of cardiovascular risk in hypertensive patients: a literature review (part 1)

O.O. Torbas, S.M. Kushnir, Yu.M. Sirenko

Abstract


Arterial hypertension (AH) remains one of the most common non-infectious diseases in Ukraine and all around the world that is associated with high levels of disability and morta­lity. In clinical practice routine blood pressure (BP) measurement allows assess condition of the hypertensive patient quickly, but causes underestimation of some clinical parameters. These findings forced the researchers to study the structure of arteries and to find methods for non-invasive measurement of central BP. The impulse for the development of technological principles for the method of contour pulse wave analysis were experiments with sphygmography and sphygmomanometry, which showed that normal fluctuations of the arterial wall is almost equal to the change of pressure phases because the artery wall behaves as a completely elastic material. This finding is the basis for the transfer function that allows non-invasive measuring central BP. Many clinical studies have shown that central BP level is better associated with target organ damage. In addition, different groups of antihypertensive drugs were found to have different effects on the aortic BP. Non-invasive measurement of central BP allows match therapy individually for hypertensive patients and conduct thorough examination of the patients of any cardiovascular risk. Determining pulse wave velocity is used for the diagnosis of arterial stiffness because its increasing is a proven risk factor for major cardiovascular complications. Diagnostic procedure of BP measurement in the aorta and arterial stiffness assessment in real practice take a lot of time; require specific, usually very expensive equipment and appropriate staff training. Nowadays a number of electronic BP monitors for office BP measurement was developed. They are based on the technology of pulse wave registration with a cuff that provides a simple measurement of BP in the aorta and other parameters of the pulse wave. One of these devices was offered by the domestic producers.

Keywords


arterial hypertension; cardiovascular risk; review

References


Association for the Advancement of Medical Instrumentation. ANSI/AAMI ES60601-1:2005/(R)2012 and A1:2012, C1:2009/(R)2012 and A2:2010/(R)2012 // 2013. — the Association for the Advancement of Medical Instrumentation.

Barnett G.O. Relationship of aortic pressure and diame­ter in the dog / Barnett G.O., Mallos A.J., Shapiro A. // J. Appl. Physiol. — 1961. — 16. — Р. 545-548.

Chen C.H. Estimation of central aortic pressure waveform by mathematical transformation of radial tonometry pressure. Validation of generalized transfer function / Chen C.H., Nevo E., Fetics B., Pak P.H., Yin F.C., Maughan W.L., Kass D.A. // Circulation. — 1997. — 95. — Р. 1827-1836.

Dahlöf B. Prevention of cardiovascular events with an antihypertensive regimen of amlodipine adding perindopril as required versus atenolol adding bendroflumethiazide as required, in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA): a multicentre randomised controlled trial / Dahlöf B., Sever P.S., Poulter N.R. [et al.], ASCOT Investigators // Lancet. — 2005. — N 366(9489). — Р. 895-906.

Fuchs M. Pulse wave velocity of the normal and diseased vessels / Fuchs M. // Arch. Kreislaufforsch. — 1952. — 18. — Р. 152-155.

Hashimoto J. Central hemodynamics and target organ damage in hypertension / Hashimoto J. // Tohoku J. Exp. Med. — 2014. — N 233(1). — Р. 1-8.

Kozin E. Carotid blowout management #251 / Kozin E., Kapo J., Straton J., Rosielle D.A. // J. Palliat. Med. — 2012. — Vol. 15(3). — P. 360-1.

Mancia G. 2013 ESH/ESC Guidelines for the management of arterial hypertension: the Task Force for the management ofarterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) / Mancia G., Fagard R., Narkiewicz K., Redón J., Zanchetti A., Böhm M., Christiaens T., Cifkova R., De Backer G., Dominiczak A., Galderisi M., Grobbee D.E., Jaarsma T., Kirchhof P., Kjeldsen S.E., Laurent S., Manolis A.J., Nilsson P.M., Ruilope L.M., Schmieder R.E., Sirnes P.A., Sleight P., Viigimaa M., Waeber B., Zannad F. // Journal of Hypertension. — 2013. — Vol. 31. — Р. 1281-1357.

Murgo J.P. Aortic input impedance in normal man: relationship to pressure wave forms / Murgo J.P., Westerhof N., ­Giolma J.P., Altobelli S.A. // Circulation. — 1980. — N 62(1). — Р. 105-121.

Schroeder W.Z. A simple apparatus for amplification of arterial pulse pressure, and continuous electronoptic registration of pulse-wave velocity / Schroeder W.Z. // Z. Gesamte Exp. Med. — 1951. — 117(2). — Р. 181-188.

Skinner S. A clinical guide. Pulse wave analysis / Skinner S. // SphygmoCor. AtCor LTD Australia, 2007.

Державна служба статистики України: Демографічна та соціальна статистика / Охорона здоров’я. Захворюваність населення (за даними Міністерства охорони здоров’я). — http://www.ukrstat.gov.ua/.




DOI: https://doi.org/10.22141/2224-1485.2.52.2017.101293

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