Renal dysfunction in patients with stage 1-2 arterial hypertension and its relationship with cardiovascular remodeling and vascular wall stiffness

The study aimed to reveal the nature of the relationship between morphofunctional changes in the heart and blood vessels, indicators of renal dysfunction, and vascular wall stiffness in patients at the initial stages of essential arterial hypertension. A one-stage cohort sample study included 137 patients with essential hypertension stage 1-2, 1-2 degrees. was carried out. A group of 60 healthy people of similar age and gender distributions was used for control. The glomerular filtration rate eGFR (formula CKD-ERI) and the level of albuminuria were determined. Arterial blood pressure was monitored for 24-h, the calculation of the stiffness of the vascular wall using the Vasotens Office application package was carried out. The mean daytime, nighttime, and daily values of time (RWIT) and pulse wave velocity in the aorta (PWVAo), augmentation index (ALo), and central aortic pressure (CAP) were calculated. Based on the ultrasound examination of the heart and blood vessels, the main indicators of cardiovascular remodeling were calculated - the left ventricular mass index with the frequency of left ventricular hypertrophy (LVH), the left atrial index (LAI), the wall thickness of the common carotid artery, the frequency of atherosclerotic plaques in the common and internal carotid arteries. Results: in patients with essential arterial hypertension, there was a decrease in eGFR and an increase in the level of albuminuria compared with the control group, associated with remodeling of the heart (an increase in the left atrium, the frequency of left ventricular hypertrophy) and blood vessels (an increase in atherosclerotic plaques). A decrease in eGFR to 89-60 ml/min/1.73 m2 was associated with higher level of indicators of vascular wall stiffness during 24-hour monitoring. Conclusion: albuminuria in patients with stage 1-2 arterial hypertension is directly associated with the level of office systolic blood pressure, and eGFR was inversely associated with the size of the left atrium, IMT, and aortic augmentation index.

артериальная гипертензия, жесткость сосудистой стенки, ренальная дисфункция, arterial hypertension, arterial wall stiffness, renal dysfunction

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