Hypertensive crisis as cerebrovascular disease risk factor

• Main Authors: M A Kravchenko, O S Andreeva, E V Gnedovskaya, A O Chechetkin, Yu Ya Varakin, E V Oshchepkova, M A Piradov
• Format: Article
• Language: Russian
• Published: IP Morozov P.V. 2018-06-01
• Series: Системные гипертензии
• Subjects: hypertensive crisis; stroke; risk factors; epidemiology; cerebrovascular disease
• Online Access: https://syst-hypertension.ru/2075-082X/article/viewFile/29608/pdf_1

Objective. To assess main epidemiological indicators for hypertensive crises (HC) in the population of productive age and to study possible correlations of crisis associated arterial hypertension (AH) with clinical and instrumental phenomenon of chronic cerebrovascular diseases. Materials and methods. Data of several studies presented: cross-sectional studies of 726 people aged 35-64 and 415 people aged 40-59. Observational cohort study of 109 patients aged 57.4±5.8 with uncomplicated AH. For the detection of HC in anamnesis, there were used special criteria which widens standard HC definition for additional account of light and mild severity cases. Results. Overall AH prevalence was 45% (95% CI 41-51), in men - 48% (40.2-55.9), in women - 45% (38.4-51.6). History of HC in anamnesis was 11.8% (95% CI 9-15.2), in men 8.8% (5.4-14) and in women - 13.8% (10-18.7). Proportion of HC associated AH defined at the level of 25-30% of all AH cases. The most prevalence of HC associated AH was found in people with “high normal” (130-139/85-89) arterial pressure - 37%. Prevalence of the complaints on headaches, dizziness, poor memory and lower intellectual productivity was higher in people with HC. Chronic cerebrovascular disease was found 2-fold frequently in HC associated AH. But in generally analysis of possible correlations of HC with clinical and instrumental phenomenon of chronic cerebrovascular diseases didn’t revealed any statistically significant differences. Conclusion. HC burden for healthcare system is serious, because it is important risk factor for cerebrovascular diseases and associated with significant lowering of the quality of life. Prevalence of the HC cases with light and mild severity is underestimated. Despite that the study of the most prevalent forms of HC (rare, light and mild severity) didn’t find any associations with morphological or persistent clinical pathology, functional phenomenon were found statistically significant frequently.