Features of the reaction of the sympathetic adrenaline system to emotional excitement in comorbid patients with arterial hypertension

The aim of the work: to identify the essential signs of the reaction of the sympathetic adrenal system (SAS) to emotional arousal in comorbid patients with arterial hypertension (AH). Objectives: 1) to find signs of increased SAS activity during emotional arousal; 2) to assess the clinical significance of increased SAS activity; 3) to assess the practical significance of identifying signs of increased SAS activity.
The study involved 105 patients with hypertension and coronary heart disease (CHD), chronic heart failure (CHF), cardiosclerosis, as well as patients with autonomic dysfunction syndrome (ADS) and hypertensive response of arterial pressure (AP). The subjects underwent a series of four stimuli of emotional arousal in a clinical roleplaying game with the registration of hemodynamic parameters. The ACS reaction was assessed by the degree of deviation of parameters in the state of arousal and rest. Then, the degree of expression and frequency of occurrence of clinical, social, anthropometric signs were calculated depending on the type of ACS reaction.
Conclusions: 1) Signs of increased ACS activity in response to emotional arousal were found: an increase in systolic blood pressure (SBP) ≥ 18 mm Hg, mean hemodynamic pressure (MHP) ≥ 10 mm Hg, pulse pressure (PP) ≥ 7 mm Hg. and an increase in the double product (DP) by 1.135 times. The change in the DP indicator most fully reflects the reactivity of the SAS; 2) An increased reaction of the SAS occurs in the presence of cardiovascular risk (CVR), and is characterized by a higher incidence of cardiosclerosis, CHF, ischemic heart disease, and more frequent prescription of antihypertensive drugs; 3) Signs of an increased reaction of the SAS to emotional arousal were more often detected in women over 55 years old. With an average to very high CVR, an increase in SBP above the threshold was observed in 33.3 %, DP – in 45.2 %, SBP – 39.8 %, DP – 77.4 % of cases.

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