[Hemodynamic types in arterial hypertension, and their changes under physical exercise]

Mismatch between the volume of blood entering the arterial circulation and the capacity of the latter presents the direct cause of arterial hypertension (AH), regardless its ethiology and pathogenesis. In most cases, it results from arteriolar spasm and increased blood flow resistance, or with increased cardiac output, which determines the type of hemodynamics. The aim of this investigation was to study central and peripheral hemodynamics in AH as well as to assess cardiovascular system reactivity under graduated physical exercise taking into account the type of hemodynamics and examinees" age. One hundred and nine patients aged 18 to 40 years with stage I to II AH were examined; 32 young healthy volunteers constituted the control group. All the subjects underwent veloergometry; vascular wall condition and hemodynamics were studied by volume compression oscillometry. The study found that in young AH patients hyperkinetic hemodynamic type prevailed; mismatch between arteriolar passability and increased cardiac output was obvious, which demonstrated that pathological changes in microcirculation were primary, while the tone of large vessels had not changed yet. AH patients with the hypokinetic variant of hemodynamics were most intolerant to physical load. The study also revealed that an excessive blood pressure response during veloergometry was more frequent in older patients (30 to 40 years).