Features of vascular walls' Remodeling in patients suffering from arterial hypertension and characterized by different temperaments and anxiety levels

The purpose of the study is to determine the thickness of “intima-media” complex of the brachial artery in men of different temperament, high and low anxiety, suffering from arterial hypertension of the II stage, 2d degree, risk 3. We tried to assess the possibility of the “empirical” 18-month antihypertensive therapy to bring the values of the “intima-media” complex to the values characteristic of healthy individuals of appropriate temperament. Ambulatory subjects were males (n = 413, the average age 54,2 ± 1,8) suffering from arterial hypertension-II. A control group consisted of 415 healthy men. The following aspects were studied: the thickness of “intima-media”complex; the diameter and the linear speed of the blood flow in the brachial artery in high- and low anxiety choleric, sanguine, phlegmatic and melancholic patients; the activity of the sympathetic and parasympathetic autonomic nervous systems; the content of cortisol and aldosterone as hormones affecting the growth and proliferation of cells and tissues. Antihypertensive therapy consisted of angiotensin-converting enzyme inhibitors or β-adrenergic blockers and diuretics without purposeful adema prevailing activity of the sympathetic nervous system or activity of the rennin-angiotensin-aldosterone system of the patient. This therapy is called ‘experimental”. Depression, mild degree of high anxiety in phlegmatic and melancholic patients was controlled by antidepressant, and high anxiety in choleric and sanguine patients was controlled by anksiolitik. In high- and low anxiety choleric and sanguine patients activity of sympathetic division of the autonomic nervous system prevailed, and in phlegmatic and melancholic patients parasympathetic division of the autonomic nervous system was more active. The content of aldosterone, the thickness of “intima-media” complex, and linear blood flow velocity increased. The content of cortisol and the brachial artery diameter decreased in patients in the following order: choleric - sanguine - phlegmatic - melancholic. Values of indicators in high anxiety patients were less positive than in low anxiety patients and worse than those in healthy individuals of appropriate temperament. No significant results in the achievement of the targeted values during the 18-month empirical antihypertensive therapy were noted. In the groups of high anxiety phlegmatic and melancholic patients the share of persons with complications was 1,5 times higher than in the groups high anxiety choleric and sanguine patients. Phlegmatic and melancholic patients of high anxiety belong to the risk group of severe hypertension.