AUTONOMIC NERVOUS SYSTEM ACTIVITY ASSESSMENT IN PATIENTS WITH HYPERTEN- SION AND HYPERVENTILATION SYNDROM MANIFESTATIONS
Journal: Art of Medicine (Vol.3, No. 2)Publication Date: 2019-05-28
Authors : I.V. Zarivna V.A. Levchenko I.I. Svystun L.V. Levchenko A.I. Ovchar;
Page : 42-47
Keywords : hypertension; activity of autonomic nervous system; hyperventilation syndrome;
Abstract
The research of the autonomic nervous system tone has been conducted among patients with the 1st degree of hypertension, among them – 82 patients had the manifestations of hyperventilation syndrome (the main group). The control group consisted of 14 patients with hypertension without manifestations of hyperventi- lation syndrome. During the research in the first group blood pressure, measured in the clinic, the systolic blood pressure was (151, 44±0,44) mm Hg. and diastolic – (86,95±0,71) mm Hg. In the control group systolic blood pressure was 146,0±1,56mm Hg., and diastolic blood pressure was 80,71±1,63 mm Hg. Patients did not get the hypotensive therapy before the research. According to the Nijmegen questionnaire hyperventilation syndrome was manifested among patients, in the first group it was 33,05±0,62 points to 14,86±1,14 points received in the control group of patients. The main variability indicators such as SDNN, RMSSD, HF, LF, VLF were studied in the research. The research on ВСР in the main and con- trol groups revealed patients with signs of simultaneous sympathicotonia and parasympathicotonia, relevant sym- pathicotonia, sympathicotonia with normal parasympath- icotonia under the normal sympathetic activity, with decreased sympathetic and parasympathetic activity, and with normotonia. The synergy of sympathetic and parasympathetic activity was revealed in the 41, 46 % of patients from the main group, against 21, 43 % received in the control group; relevant sympathicotonia was observed in the 34,15 % and 14,29 % cases respectively; sympathicotonia under normal parasymphatic activity was revealed in 12,20 % and 7,14 % respectively. Under the synergy of sympathetic and parasym- pathetic activity among patients of the first group reliable increase in numbers of LF (1443,6±52,15) vс2 was ob- served, VLF (686,25±16,22) vc2, SDNN (60,41±1,63) vс and HF (640,18±29,38) vс2. Given “focused agonism” has demonstrated the increasing activity of one depart- ment of the automatic nervous system under the certain physiological condition that leads to compensatory stretching of another, that means the system is reversing to normal or close to normal homeostasis, including blood pressure. The results of conducted research proved that among patients with the 1st type of hypertension and symptoms of hyperventilation syndrome mostly were prevalent indicators which reflect the tension of autonomic nervous system regula- tions, increase in resource mobilization of the sympathetic department, in comparison to the results got among patients with hypertension but without manifestations of hyperventila- tion. It needs certain correction that can be achieved through the normalization of the pattern breathing by the systemic usage of the diaphragmatic breathing. As the decrease of diaphragm amplitude that occurs under hy- perventilation syndrome can lead not only to the worsen- ing of lung ventilation values, but also to formation of hypocapnia, respiratory alkalosis, endothelial dysfunc- tion, violation of the processes of local autoregulations, angiospastic reconstruction, etc. cerebral flow that leads to the increase of AP. The analysis of variability of the heartbeat is highly informative and accessible non-invasive method for indicating of the autonomic regulation's condition among patients with hypertension. It is one of the methods of the efficiency of standard hypotensive treatment assessment, of its correction on the background of risk factors and concomitant diseases.
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