Mishchenko L. Disturbance of circadian blood pressure rhythm in essential hypertensive patients and its relation with neurohumoral factors of blood pressure regulation.

The dissertation is devoted to the circadian blood pressure (BP) rhythm characteristics and its relation with humoral vasoactive factors in essential hypertensive patients with different types of BP 24-hour profile and to evaluation of its changes under antihypertensive treatment. The parameters of 24-hour BP monitoring and content of catecholamines, insuline and ACE activity were studied in patients with normal BP circadian rhythm and in patients with disturbance of BP circadian rhythm, and also the possibilities antihypertensive treatment in correction of revealed breaches. There were 54% with disturbance of BP circadian rhythm among examined essential hypertensive patients: 40% non-dippers, 9% over-dippers and 5% night-pikers. The patients with the lack of nocturnal BP fall (non-dipper) in compare with dippers are characterized by the lower plasma adrenaline, noradrenaline concentration and ACE activity, and by the latent hyperinsuliemia, which become evident under glucose load. The antihypertensivetreatment improves the parameters of BP 24-hour profile, makes a favorable influence on activity of sympathetic and renin-angiotensin systems and glucose metabolism. Irbesartan treatment activated the nitric oxyde synthesis.