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[Non-pharmacological correction of arterial pressure in hypertensive patients with a pacemaker]
Insights
Cardiac pacing (CP) can lower blood pressure in hypertensive patients. Programmed frequency adjustments offer a non-pharmacological approach to manage hypertension, optimizing anti-hypertensive treatment effectiveness.
Area of Science:
- Cardiology
- Hypertension Management
Context:
- Essential hypertension affects a significant portion of the population, necessitating effective non-pharmacological treatment options.
- Cardiac pacing (CP) is a common intervention for various cardiac conditions, with potential for broader therapeutic applications.
Purpose:
- To investigate the frequency-dependent hypotensive effects of cardiac pacing (CP) in patients with essential hypertension.
- To determine the influence of different stimulation regimes (VVI and AAI) and circulation types on the blood pressure response to CP.
Summary:
- A study of 92 hypertensive patients revealed that programmed cardiac pacing (CP) can induce a frequency-dependent hypotensive effect.
- Increasing pacing frequency above 80 bpm significantly lowered systolic arterial pressure (SAP) in hyperkinetic patients, while frequencies below 60 bpm reduced diastolic arterial pressure (DAP) in eukinetic and hypokinetic patients.
- The VVI pacing regime demonstrated a more pronounced hypotensive effect than the AAI regime, particularly when complicated by ventriculoatrial conduction. Reprogramming normalized blood pressure in 43.3% of hyperkinetic patients.
Impact:
- Programmed cardiac pacing offers a potential non-pharmacological strategy for managing arterial hypertension.
- Optimizing pacing frequency and regime can enhance the effectiveness of anti-hypertensive treatment in patients with pacemakers.
Abstract:
Frequency-dependent hypotensive effect of cardiac pacing (CP) regarding type of circulation and stimulation regime under programmed changes of impulse frequency from 50 to 90 imp/min was studied in 92 patients (53 males, 39 females) with essential hypertension of the first, second and third degree and isolated systolic arterial hypertension. The rise of the above frequency over 80 imp/min was accompanied with a significant fall in systolic arterial pressure (SAP) in patients with hyperkinetic circulation while heart rhythm under 60 imp/min resulted in a significant lowering of diastolic arterial pressure (DAP) in patients with eukinetic and hypokinetic type of circulation. In regime VVI both SAP and DAP lowering was more pronounced than in AAI regime. The most prominent hypotensive effect was seen in VVI-stimulation complicated by ventriculoatrial conduction. Reprogramming of impulse frequency normalized arterial pressure in 43.3% patients with hyperkinetic type of circulation. Thus, a frequency-dependent hypotensive effect of programmed CP can be used for non-pharmacological correction of arterial hypertension and optimization of effectiveness of anti-hypertensive treatment in paced patients.