Features of the reaction of the renin-angiotensin-aldosterone system to emotional excitement in patients with arterial hypertension

Aim: to study the features of the renin-angiotensin-aldosterone system (RAAS) response to emotional arousal in patients with arterial hypertension (AH) and associated clinical conditions (ACS). Objectives: 1) to determine the clinical significance of the Kerdo autonomic index (KAI) in patients with hypertension and ACS; 2) to find signs of increased RAAS activity during emotional arousal; 3) to assess the clinical significance of increased RAAS activity; 4. To determine the practical significance of identifying signs of increased RAAS activity A total of 105 patients with hypertension and comorbid pathology were studied. Design: observational clinical study in specially formed groups.

Conclusions: 1) subjects with «parasympathicotonia» (KAI <-10,0) were older, among them there were more often II and III degrees of hypertension, high and very high cardiovascular risk (CVR) and chronic heart failure (CHF) of 1 and 2a degrees, while subjects with «normotonia» (-10,0 ≤ KAI ≤10,0) and «sympathicotonia» (KAI >10.0) did not differ from each other; 2) criteria for increased RAAS activity in patients with hypertension are an increase in indicators in a state of emotional arousal to the previous state of rest above the found threshold value: diastolic blood pressure (DBP) ≥4 mm Hg and KAI ≥19,0 units, as well as an increase in heart rate (HR) < 11 beats / min. 3) Clinically increased RAAS activity during emotional arousal is characterized by a higher incidence of moderate-high CVR, cardiosclerosis, and coronary heart disease (CHD); 4) No differences were found between groups with different RAAS activity by age, gender, and other social characteristics. With moderate-very high CVR, an increase in DBP above the threshold was observed in 79,6%, and a change in KAI was observed in 50,5%.

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