Dynamics of arterial pressure at patients renovascular hypertension before and after percutaneous transluminal renal angioplasty (ptra)

Arterial blood pressure monitoring enabled its daily dynamics estimation for operated patients with renovascular hypertension. 51 patients were examined before and after the surgical intervention (percutaneous transluminal angioplasty), and 52 patients with idiopathic hypertension. Renovascular hypertension diagnosis was verified on the basis of clinical, laboratory and instrumental data, as well as the results of duplex scanning of renal arteries and multispiral CT. Analysis of the clinical research of daily blood pressure dynamics is based on estimation of systolic, diastolic and pulse blood pressure average scores, their variability, physical exercise duration and daily blood pressure rhythm. It was indicated that before the surgery the daily blood pressure dynamics of the patients with renovascular hypertension were characterized by a high level of "blood pressure load" in both day- and nighttime. Such patients happened to have a much more significant daily blood pressure disruption than the ones with idiopathic arterial hypertension. Before the percutaneous transluminal angioplasty the patients with renovascular hypertension had a normal nighttime blood pressure dip half as much as compared to the patients with idiopathic arterial hypertension (20 % versus 44% respectively), or there was a subnormal dip (53% versus 39%), as well a nocturnal hypertension (23% versus 9%). Daily blood pressure rhythm disruptions of patients with renovascular hypertension, compared to the ones with idiopathic hypertension, were marked by lower pulse blood pressure, wider variability of diastolic arterial pressure in the nighttime and less significant systolic arterial pressure rises in the morning. After the percutaneous transluminal angioplasty 68% of the patients proved normalization of systolic, diastolic and pulse blood pressure with the assistance of non-medicamentous treatment methods (training for patients with arterial hypertension; graduated exercise/walking).