Comprehensive evaluation of vascular wall state in patients with arterial hypertension in different periods of ischemic stroke

Objective: to assess the indicators of arterial stiffness and endothelial function in patients with arterial hypertension (AH) in different periods of ischemic stroke (IS), depending on the degree of recovery of neurological functions. Material and Methods. We examined 180 patients aged over 40 years with AH in the acute period of IS, admitted to the neurological department from September, 2015 to June, 2019. The degree of functional independence was assessed using the modified Rankin scale (mRS). The patients were divided into 2 groups: group I — with a high level of recovery, mRS<3 (n=88) and group II — with a low level of recovery, mRS≥3 (n=92). The oscillometric method was used to assess the average daily indicators of vascular rigidity. The level of endothelin-1 (ET-1), endothelium-dependent vasodilation (ESVD) and occlusion index were investigated. The observation period was 2 months. Results. Group II in the acute period of IS is characterized by higher values of the rigidity of the vascular wall (SPW 13.8±1.8 m / s vs 11.6±1.7 m / s, p<0.05), an increase in the level of ET-1 (6,5±1.8 ng / ml vs 5.6±1.8ng / ml, p<0.05), decreased EDVD (5.0±1.2 % vs 5.9±1.4, p<0.05). After 2 months, there was a positive trend in the studied indicators in both groups. In group II, PWV decreased from 13.8±1.8 m / s to 11.8±1.6 m / s, p<0.05; in group I, PWV decreased from 11.6±1.7 m / s to 9.8±1.5 m / s, p<0.05. Conclusion. Patients with a low restorative potential showed a decrease in endothelial function and higher indicators of vascular rigidity.