Early diagnosis of increased stiffness of great vessels in adolescents with functional pathology of vegetative genesis

40 adolescents aged 15–17 years with functional cardiovascular pathology of vegetative origin underwent a 24-hour blood pressure monitoring (using the oscillometric method BPLabVasotens, Peter Telegin LLC, Nizhny Novgorod) with an assessment of central blood pressure parameters and rigidity of the main arteries.
The scientists found significantly higher values of central systolic pressure during the day and night hours in the group of adolescents with arterial hypertension (n=13) compared to adolescents with normal blood pressure (n=27). They determined significantly higher values of the pulse wave velocity both during 24 hours and in the day and night hours in the group with arterial hypertension compared to the group of adolescents with normal blood pressure. No differences were found in the parameters of the propagation time of the reflected pulse wave and the augmentation index. The time of the reflected pulse wave propagation was significantly lower at nighttime compared to the daytime. In the group with arterial hypertension, the rate of pulse wave propagation in the aorta correlated only with the values of diastolic pressure over 24 hours and diastolic pressure in the daytime. In the adolescents with normal blood pressure, the pulse wave velocity correlated with systolic and pulse blood pressure. The augmentation index in the group of adolescents with arterial hypertension correlated with diastolic pressure, in contrast to the group of adolescents with normal blood pressure, where such a correlation was not detected.

1. Williams B., Mancia G., Spiering W., Agabiti Rosei E., Azizi M., Burnier M. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018; 36(10):1953–2041. DOI: 10.1097/HJH.0000000000001940.

2. Кобалава Ж.Д., Котовская Ю.В. Артериальная гипертония в XXI веке: Достижения, проблемы, перспективы. 2-е изд., доп. перераб. М.: Бионика Медиа, 2015; 364. [Kobalava Zh.D., Kotovskaja Ju.V. Achievements, challenges, and prospects. Moscow: Bionika Media, 2015; 364. (in Russ.)]

3. Чазова И.Е., Жернакова Ю.Е. Клинические рекомендации. Диагностика, лечение артериальной гипертензии. Системные гипертензии 2019; 16(1): 6–31. [Chazova I.E., Zhernakova Yu.E. Clinical recommendations. Diagnosis and treatment of arterial hypertension. Systemic hypertension 2019; 16(1): 6–31. (in Russ.)] DOI: 10.26442/2075082X.2019.1.190179

4. Mancia G., Fagard R., Narkiewicz K., Redon J., Zanchetti A., Bohm M. et al. 2013 ESH/ESC guidelines for the management of arterial hypertension: the Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). Eur Heart J 2013; 34: 2159–2219. DOI: 10.1093/eurheartj/eht151

5. Flynn J.T., Kaelber D.C., Baker-Smith C.M., Blowey D., Carroll A.E., Daniels S.R. et al. Clinical Practice Guideline for Screening and Management of High Blood Pressure in Children and Adolescents. Pediatrics 2017; 140(3): e20171904. DOI: 10.1542/peds.2017-1904

6. Дружилов М.А., Отмахов В.В., Бетелева Ю.Е., Корнева В.А., Кузнецова Т.Я. Субклиническое поражение сосудов у нормотензивных пациентов с абдоминальным ожирением: фокус на артериальную жесткость. Системные гипертензии 2013; 10(2): 46–52. [Druzhilov M.A., Otmahov V.V., Beteleva Ju.E., Korneva T.A., Kuznetsova T.Y. Subclinical vascular damage in normotensive patients with abdominal obesity: focus on arterial stiffness. Sistemnye gipertenzii 2013; 10(2): 46–52 (in Russ.)]

7. Евсевьева М.Е., Еремин М.В., Ростовцева М.В., Сергеева О.В. Центральное аортальное давление и факторы сердечно-сосудистого риска у студентов в аспекте оптимизации диспансеризации молодежи Российский кардиологический журнал 2015, 6(122): 68–74. [Evsevyeva M.E., Eryomin M.V., Rostovtseva M.V., Sergeeva O.V. Central aortic pressure and cardiovascular risk factors assessment in students as a part of the youth screening improvement Russ J Cardiol 2015; 6(122): 68–74. (in Russ.)] DOI: org/10.15829/1560-4071-2015-06-68-74

8. Savant J.D., Furth S.L., Meyers K.E. Arterial Stiffness in Children: Pediatric Measurement and Considerations. Pulse (Basel) 2014; 2(1–4): 69–80. DOI: 10.1159/000374095.

9. Кобалава Ж.Д., Беленков Ю.Н., Джериева И.С., Рапопорт С.И., Волкова Н.И. Метаболический синдром как результат образа жизни. М.: Медицинское информационное агентство, 2015; 240. [Kobalava Zh.D., Belenkov Ju.N., Dzherieva I.S., Rapoport S.I., Volkova N.I. Metabolic syndrome as a result of lifestyle. Moscow: Medicinskoe informacionnoe agentstvo, 2015; 240. (in Russ.)]

10. Панченкова Л.А., Хамидов Х.А., Шелковникова М.А., Юркова Т.Е., Рассудова Н.В., Устинова М.Р., и др. Суточное мониторирование артериальной ригидности у коморбидных больных с сердечно-сосудистой патологией. Казанский медицинский журнал 2016; 1: 5–10. [Panchenkova L.a., Khamidova Kh.A., Shelkovnikova M.O., Yurkova T.E., Rassudova N.V., Ustinova M.R. et al. 24-hour arterial stiffness monitoring in comorbid patients with cardiovascular pathology. Kazanskii meditsinskii zhurnal 2016; 1: 5–10. (in Russ.)] DOI: 10.17750/KMJ2016-5

11. Nilsson P. Vascular age: how can it be determined? What are it’s clinical applications? Medicographia 2015; 37: 454–460 DOI: 10.3389/fcvm.2020.00006

12. O’Rourke M. Mechanical principles in arterial disease. Hypertension 1995; 26(1): 2–9. DOI: 10.1161/01.HYP.26.1.2

13. Laurent S. Defining vascular aging and cardiovascular risk. J Hypertens 2012; 30 (Suppl 1): S3–S8. DOI: 10.1097/HJH.0b013e328353e501

14. Laurent S., Marais L., Boutouyrie P. The Noninvasive assessment of vascular aging. Can J Cardiol 2016; 32(5): 669–79. DOI: 10.1016/j.cjca.2016.01.039 4]

15. Urbina E.M., Dolan L.M., McCoy C.E., Khoury P.R, Daniels S.R., Kimball T.R. Relationship between elevated arterial stiffness and increased left ventricular mass in adolescents and young adults. Pediatrics 2011; 158(5): 715–721. DOI: 10.1016/j.jpeds.2010.12.020

16. Urbina E.M. Abnormalities of vascular structure and function in pediatric hypertension Pediatr Nephrol 2016; 31(7): 1061– 1070. DOI: 10.1007/s00467-015-3188-1

17. Уразалина С.Ж., Рогоза А.Н., Балахонова Т.В., Кухарчук В.В., Карпов Ю.А., Бойцов С.А. Роль показателей доклинического поражения артериальной стенки в оценке риска развития сердечно-сосудистых осложнений. Кардиология 2012; 4(12): 53–59. [Urazalina S.Zh., Rogoza A.N., Balakhonova T.V., Kukharchuk V.V., Karpov Yu.A., Boytsov S.A. The contribution of parameters of subclinical artery wall damage in the evaluation of cardiovascular risk. Kardiologiya 2012; 4(12): 53–59. (In Russ.)]

18. Карпов Ю.А. Как предупредить раннее сосудистое старение у пациентов с артериальной гипертонией? Атмосфера. Новости Кардиологии 2016; 3: 2–10. [Karpov Yu.A. How to prevent early vascular aging in patients with arterial hypertension? Аtmosfera. Novosti Kardiologii 2016; 3: 2–10. (In Russ.)]

19. Недогода С.В. Эластичность крупных сосудов – новая мишень фармакотерапии. М.: Медиа Медика, 2008; 288. [Nedogoda S.V. The elasticity of major blood vessels – a new target target of pharmacotherapy. Moscow: Media Medika, 2008; 288. (In Russ.)]

20. Александров А.А., Кисляк О.А., Леонтьева И.В. Клинические рекомендации Диагностика, лечение и профилактика артериальной гипертензии у детей и подростков. Системные артериальные гипертензии 2020; 17(2): 7–35. [Alexandrov A.A., Kislyak O.A., Leontieva I.V. Clinical recommendations Diagnosis, treatment and prevention of arterial hypertension in children and adolescents. Sistemnye arterial’nye gipertenzii (Systemic arterial hypertension) 2020; 17(2): 7–35. (In Russ.)] DOI: 10.26442/2075082X.2020.2.200126

21. Müller J., Oberhoffer R., Barta C., Hulpke-Wette M., Hager A. Oscillometric Carotid to Femoral Pulse Wave Velocity Estimated With the Vicorder Device. J Clin Hypertens 2013; 15(3): 176–179. DOI: 10.1111/jch.12045

22. Diaz A., Zócalo Y., Bia D., Fischer E. Reference Intervals of Central Aortic Blood Pressure and Augmentation Index Assessed with an Oscillometric Device in Healthy Children, Adolescents, and Young Adults from Argentina. Int J Hypertens 2018; 2018: 1469651. DOI: org/10.1155/2018/1469651

23. Thurn D., Doyon A., Sözeri B., Bayazit A.K., Canpolat N., Duzova A. et al. Aortic Pulse Wave Velocity in Healthy Children and Adolescents: Reference Values for the Vicorder Device and Modifying Factors. Am J Hypertens 2015; 28(12): 1480– 1488. DOI: 10.1093/ajh/hpv048.

24. Elmenhorst J., Hulpke-Wette M., Barta C., Dalla Pozza R., Springer S., Oberhoffer R. Percentiles for central blood pressure and pulse wave velocity in children and adolescents recorded with an oscillometric device. Atherosclerosis 2015; 238(1): 9–16. DOI: 10.1016/j.atherosclerosis.2014.11.005.

25. Stoner L., Kucharska-Newton A., Meyer M.L. Cardiometabolic Health and Carotid-Femoral Pulse Wave Velocity in Children: A Systematic Review and Meta-Regression. J Pediatr 2020; 218: 98–105.e3. DOI: 10.1016/j.jpeds.2019.10.065

26. Li E., Hasele E., Chowienczyk P., Sinha M. Haemodynamics of Hypertension in Children. Curr Hypertens Rep 2020; 22: 60. DOI: 10.1007/s11906-020-01044-2

27. Litwin M., Feber J., Ruzicka R. Vascular Aging: Lessons From Pediatric Hypertension. Canad J Cardiol 2016; 32(5): 642– 649. DOI: 10.1016/j.cjca.2016.02.064

28. Obrycki Ł., Feber J., Derezinski T., Lewandowska W., Kułaga Z., Litwin M. Hemodynamic Patterns and Target Organ Damage in Adolescents With Ambulatory Prehypertension Hypertens 2020; 75(3): 826–834. DOI: 10.1161/HYPERTENSIONAHA.119.14149

29. Wójtowicz J., Łempicka A., Łuczyński W, Szczepański A., Zomerfeld K., Semeran B., Bossowski A. Central aortic pressure, arterial stiffness and echocardiographic parameters of children with overweight/obesity and arterial hypertension Adv Clin Exp Med 2017; 26(9): 1399–1404. DOI: 10.17219/acem/65485

30. Garcia-Espinosa V., Curcio S., Marotta M., Castro J.M., Arana M., Peluso G. et al. Changes in central aortic pressure levels, wave components and determinants associated with high peripheral blood pressure states in childhood: analysis of hypertensive phenotype. Pediatr Cardiol 2016; 37(7): 1340–50. DOI: org/10.1007/s00246-016-1440-5