Features of central aortic pressure at patients with arterial hypertension aged 80 years and older, taking into account the presence of chronic heart failure and senile asthenia syndrome

Objective: to evaluate the parameters of central aortic pressure in patients with arterial hypertension (AH) depending on the presence of chronic heart failure (CHF) and senile asthenia syndrome (SSA). Materials and methods: 320 patients with AH were divided into four groups: group 1A — patients with AH, SSA and CHF (n=84), group 1B — patients with AH, SSA without CHF (n=84), group 2A — patients with AH, CHF without SSA (n=77), group 2B — patients with AH without CHF and without SSA (n=75). Central aortic pressure parameters were determined using a BPLab ABPM device using Vasotens technology (“Petr Telegin”, Nizhny Novgorod). To process the obtained data, statistical programs STATISTICA 12.0, SPSS 21.0, MedCalc 9.3.5.0 were used. Results: in patients with AH, CHF and SSA, higher average daily values of SBP ao were recorded compared to both patients with AH and CHF without SSA (p=0.004) and with AH, SSA without CHF (p=0.019). The presence of SSA led to higher AIx ao values both in patients with hypertension, SSA and CHF (p<0.001), and in patients with AH and SSA without CHF (p<0.001). In patients with AH and CHF, regardless of the presence of SSA, higher rates of PBP ao (p<0.001), AIx ao (p<0.001), ED (p<0.001) and lower rates of SERV (p<0.001) were recorded. When assessing the degree of influence of CHF or SSA, it was shown that CHF had a more pronounced effect on PBP ao (p<0.001), ED (p<0.001) and SERV (p<0.001) indicators than SSA. Conclusion: in patients with AH aged 80 years and older, the development of both SSA and, to a greater extent, the presence of CHF was accompanied by an increase in central aortic pressure. With a combination of AH, CHF and SSA, the most pronounced disturbances in the elastic properties of blood vessels were observed, which is associated with a high cardiovascular risk.

1. Fadah K., Hechanova А., Mukherjee D. Epidemiology, pathophysiology and management of coronary artery disease in the elderly. Int J Angiol. 2022;31(4):244-250. https://doi.org/10.1055/s-0042-1751234.

2. Tkacheva O.N., Belenkov Yu.N., Karpov Yu.A., Zyryanov S.K. Gerontology Issues in Cardiology Practice. Kardiologiia. 2019;59(12):54-63. (In Russ.) https://doi.org/10.18087/cardio.2019.12.n876

3. Davidov E.L., Тihonova N.V., Glushanko V.S., Shulmin A.V., Zakharova A.S. Asthenic syndrome in elderly people: diagnostic, treatment and rehabilitation trends. Siberian Medical Review. 2020;(5):40-48. (In Russ.) https://doi.org/10.20333/2500136-2020-5-40-48

4. Khazova E.V., Smetanina E.D., Malkova M.I. Senile asthenia syndrome in patients with cardiovascular diseases: issues of epidemiology, diagnosis, prognosis. Medical almanac. 2023;3(76):98-106. (In Russ.). eLIBRARY ID: 54678736 EDN: YELHVQ

5. Díez-Villanueva P, Jiménez-Méndez C, Bonanad C, GarcíaBlas S, Pérez-Rivera Á, et al. Risk Factors and Cardiovascular Disease in the Elderly. Rev Cardiovasc Med. 2022;23(6):188. https://doi.org/10.31083/j.rcm2306188

6. Kuznetsov A.A., Tsvetkova E.E., Denisova D.V., Ragino Yu.I., Voevoda M.I. Central Aortic Pressure: Reference and Diagnostic Values. Kardiologiia. 2019;59(3):11-17. (In Russ.) https://doi.org/10.18087/cardio.2019.3.10235

7. Mancia G, Laurent S, Agabiti-Rosei E, Ambrosioni E, Burnier M, et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. Blood Press. 2009;18(6):308-347. https://doi.org/10.3109/08037050903450468

8. Kotovskaya Yu.V., Kobalava Zh.D. Aortic pressure: modern ideas about the clinical and prognostic significance of its indicators. Medical advice. 2013;9:26-33. (In Russ.). eLIBRARY ID: 21168715 EDN: RVGCRL

9. Radova N.F., Nunuparova M.M. The central aortic blood pressure. Clinical value and the forecast. Medical alphabet. 2017;3(39):21-27. (In Russ.). eLIBRARY ID: 32368069 EDN: YNMLVO

10. Safronenko V.A., Chesnikova A.I., Sementsova N.A. Features of vascular rigidity in patients with arterial hypertension in combination with chronic heart failure and senile asthenia syndrome. "Arterial’naya Gipertenziya" ("Arterial Hypertension"). 2022;28(6):659-668. (In Russ.) https://doi.org/10.18705/1607-419X-2022-28-6-659-668

11. Kobalava Zh.D., Konradi A.O., Nedogoda S.V., Shlyakhto E.V., Arutyunov G.P., et al. 2024 Clinical practice guidelines for Hypertension in adults. Russian Journal of Cardiology. 2024;29(9):6117. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6117. EDN: GUEWLU

12. Galyavich A.S., Tereshchenko S.N., Uskach T.M., Ageev F.T., Aronov D.M., et al. 2024 Clinical practice guidelines for Chronic heart failure. Russian Journal of Cardiology. 2024;29(11):6162. (In Russ.) https://doi.org/10.15829/1560-4071-2024-6162. EDN: WKIDLJ

13. Clinical practice guidelines for Senile asthenia. (In Russ.). Accessed 02.09.2024. URL: https://diseases.medelement.com/disease/%D1%81%D1%82%D0%B0%D1%80%D1%87%D0%B5%D1%81%D0%BA %D0%B0%D1%8F-%D0%B0%D1%81%D1%82%D0%B5%D0 %BD%D0%B8%D1%8F-%D0%BA%D0%BF-%D1%80%D1%84-2024/18021

14. Safronenko V.A., Chesnikova A.I., Safronenko A.V., Skarzhinskaya N.S., Kuznetsov I.I., Nasytko A.D. Clinical traits of chronic heart failure in patients with arterial hypertension and senile asthenia syndrome: an observational cross-sectional study. Kuban Scientific Medical Bulletin. 2021;28(4):25- 40. (In Russ.) https://doi.org/10.25207/1608-6228-2021-28-4-25-40

15. Tsao CW, Lyass A, Larson MG, Levy D, Hamburg NM, et al. Relation of Central Arterial Stiffness to Incident Heart Failure in the Community. J Am Heart Assoc. 2015;4(11):e002189. https://doi.org/10.1161/JAHA.115.002189

16. Kotovskaya Yu.V., Rogoza A.N., Orlova Ya.A., Posokhov I.N. Ambulatory pulse wave monitoring: current and future. Opinion paper of Russian Experts. Cardiovascular Therapy and Prevention. 2018;17(6):95-109. (In Russ.) https://doi.org/10.15829/1728-8800-2018-6-95-109

17. Vlachopoulos C, Aznaouridis K, O'Rourke MF, Safar ME, Baou K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with central haemodynamics: a systematic review and meta-analysis. Eur Heart J. 2010;31(15):1865-1871. https://doi.org/10.1093/eurheartj/ehq024

18. Verdecchia P, Reboldi G, Mazzotta G, Angeli F. The Progetto Ipertensione Umbria Monitoraggio Ambulatoriale (PIUMA) Study. Panminerva Med. 2021;63(4):464-471. https://doi.org/10.23736/S0031-0808.21.04383-4

19. Teregulov Yu.E., Mayanskaya S.D., Teregulova E.T. Changes in elastic properties of arteries and hemodynamic processes. Practical medicine. 2017;(2):14-20.(In Russ.). eLIBRARY ID: 29044730 EDN: YLPFTZ

20. Xue Q, Qin MZ, Jia J, Liu JP, Wang Y. Association between frailty and the cardio-ankle vascular index. Clin Interv Aging. 2019;14:735-742. https://doi.org/10.2147/CIA.S195109

21.

22.