Krutost žila u hipertoničara s hipertenzivnom krizom mjereno oscilometrijskom metodom

master's thesis

• Title (english): Pulse wave velocity in hypertensive patients with hypertensive crisis measured by oscillometric method
• Author: Lucija Bilinovac
• Mentor: Ingrid Prkačin (mentor)
• Committee member: Bojan Jelaković (predsjednik povjerenstva)
• Committee member: Jasenka Markeljević (član povjerenstva)
• Committee member: Ingrid Prkačin (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2019-07-12, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Emergency Medicine

Abstract

UVOD: Hipertenzivna kriza definirana je vrijednošću sistoličkog krvnog tlaka višom od 180 mmHg ili dijastoličkog krvnog tlaka višom od 120 mmHg i može se javiti kao prva manifestacija arterijske hipertenzije. Razlikujemo hipertenzivnu emergenciju u kojoj osim naglog skoka krvnog tlaka dolazi i do oštećenja organa, i hipertenzivnu urgenciju u kojoj ne dolazi do oštećenja organa. Bolesnike s hipertenzivnom krizom potrebno je klinički obraditi kako bi se isključili sekundarni uzroci hipertenzije. PWV je mjera krutosti žila direktno povezana s kardiovaskularnim rizikom i asimptomatskim oštećenjem ciljnih organa u hipertenziji. Neinvazivno mjerenje krutosti žila je nova metoda koja ima mjesto u dijagnostičkom algoritmu bolesnika s hipertenzivnom krizom. ----- CILJEVI RADA: Cilj ovog istraživanja bio je prikazati mjerenje krutosti krvnih žila u hitnoj službi kao neinvazivnu metodu procjene KV rizika bolesnika s hipertenzivnom urgencijom. ----- ISPITANICI I METODE: Ovo istraživanje uključivalo je 17 bolesnika s hipertenzivnom urgencijom koji su se javili u Hitnu službu Klinike za unutarnje bolesti u KB Merkur u Zagrebu u razdoblju od veljače do lipnja 2019. godine. Bolesnicima je izmjerena krutost žila neinvazivnom metodom, uređajem „Agedio B900“ koji radi na principu oscilometrije. ----- REZULTATI: Prosječna dob ispitanika bila je 64,18 ± 10,87 godina. 58,82% činile su žene, a 41,18% muškarci. Prosječni brahijalni sistolički krvni tlak kod svih je ispitanika bio viši od 180 mmHg, što je kriterij za hipertenzivnu krizu, i iznosio je 191,17 ± 10,98 mmHg. Vrijednost PWV kod svakog je bolesnika bila viša od referentne vrijednosti za dob i prosječno je iznosila 10,5 ± 2,01 m/s. ----- ZAKLJUČAK: Bolesnici koji se prezentiraju u hitnoj službi s hipertenzivnom krizom po tipu urgencije imaju povišene vrijednosti PWV u odnosu na referentne vrijednosti i u odnosu na pacijente s rezistentnom hipertenzijom.

Abstract (english)

INTRODUCTION: Hypertensive crisis is defined by the systolic pressure higher than 180 mm Hg or diastolic pressure higher than 120 mm Hg and it can be the first manifestation of arterial hypertension. In hypertensive emergency, in addition to severe blood pressure elevation, there is evidence of organ damage, while in hypertensive urgency there is no organ damage. Patients with hypertensive crisis require thorough clinical assessment in order to exclude secondary causes of arterial hypertension. PWV is the measure of arterial stiffness which is directly connected to cardiovascular risk and hypertension mediated organ damage. Noninvasive measurement of arterial stiffness is a novel method in the diagnostic algorithm for patients with hypertensive crisis. ----- AIM: The aim of this study was to show the measurement of arterial stiffness in an emergency room setting as a noninvasive method of assessing cardiovascular risk in patients with hypertensive urgency. ----- PATIENTS AND METHODS: This study included 17 patients presenting with hypertensive urgency to the Emergency room of Clinic for internal medicine, University Hospital Merkur in Zagreb from February to June 2019. Arterial stiffnes were measured for all patients with a noninvasive method using „Agedio B900“, the device operating on the principle of oscillometry. ----- RESULTS: Average age of patients was 64,18 ± 10,87 years. 58,82% were female and 41,18% were male. Average brachial systolic BP was higher than 180 mm Hg which is a criterion for hypertensive crisis, and it was 191,17 ± 10,98 mm Hg. PWV for each patient was higher than the reference range for age with values of 10,5 ± 2,01 m/s. Conclusion This study showed that the patients presenting to the ER with hypertensive urgency have higher PWV values when compared to the reference range and to patients with resistant hypertension.

• Keywords: hipertenzivna kriza; hipertenzivna emergencija; hipertenzivna urgencija; PWV; krutost krvnih žila
• Keywords (english): hypertensive crisis; hypertensive emergency; hypertensive urgency; PWV; arterial stiffness
• Language: croatian
• URN:NBN: urn:nbn:hr:105:742072
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Public note: Pohranitelj objekta unio ključne riječi.
• Created on: 2020-06-12 08:46:56