THE EFFECT OF COVID-19 ON NOCTURNAL BLOOD PRESSURE ELEVATION IN PATIENTS WITH ARTERIAL HYPERTENSION

Objective: to evalute the effect of COVID-19 on the degree of nocturnal decrease in blood pressure (BP) against the background of antihypertensive therapy (AHT) in patients with arterial hypertension (AH). Design and method: 74 male and female patients with I-III degree of AH(ESH/ESC, 2018) were studied. The mean age of patients was 53.54±1.92 years,duration of AH was 8.61 years. 2 groups of patients were identified: I – patients with AH who had suffered COVID19, (n=42) and 2nd group – patients with AH who had not suffered COVID-19 (n=32). All patients before and 6 months of therapy measured office BP and DBPM. The daily rhythm of blood pressure was determined based on the degree of nocturnal decrease in SBP (DND SBP). Based on the DND SBP data, patients were divided into: “dippers”, “non-dippers”, “over-dippers”, “night pickers”. All patients were prescribed dual or triple AHT. The results are presented as M±SD. Results: Significant improvement in the circadian rhythm of BP with a high degree of reliability in 2nd group of patients initially amounted to 5.31±5.88% in dynamics - 11.6±3.81% (p<0.001). In 1nd group DND SBP initially was 4.8±5.8% versus– 6.3±4.4% (p > 0.01). In 1st group of patients, the number of non-dippers predominated - 53.8%, while night pickers were 15.40%, dippers - 30.8%. A similar picture was observed in group II of patients: 50.0%: 20.0%: 30.0%. Intergroup differences were not significant (χ 2 =0.086, p=0.958). Analysis of the dynamics of DND SBP in both groups during therapy revealed that 1st in group of patients the number of non-dippers increased significantly, amounting to 77%, while the number of dippers decreased to 23%. On the contrary, in group II of patients, the number of non-dippers and non-dippers decreased slightly to 40%, and the number of dippers significantly increased by 2 times, amounting to 60% of patients. At the same time, the intergroup difference approached significance (χ 2 = 3.23, p = 0.072) Conclusions: The previous COVID-19 made a negative contribution to the antihypertensive effectiveness in terms of the dynamics of the degree of nocturnal reduction in BP.

Перевод пока недоступен