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Climate Influence on Blood Pressure Rhythms and Left Ventricular Parameters in Hypertensive Patients: Comparative
A Sivkov1, N Chernus2, T Sakharova3
1Department of Clinical Pharmacology and Propaedeutics Internal Diseases of the Institute of Clinical Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russian Federation.
Background:
Hypertension is a prevalent condition that significantly impacts cardiovascular health. The rhythmicity of arterial blood pressure (BP) can vary based on climatic conditions, potentially influencing the severity and outcomes of hypertensive complications. The study aims to assess the characteristics of arterial blood pressure rhythmicity in hypertensive patients and their influence on the structural parameters of the left ventricle of the heart in both temperate and subarctic regions of Russia.
Methods:
The study encompassed 600 randomly selected patients with arterial hypertension, categorized into two groups based on their geographic location: Group 1 comprised patients from Moscow and the Moscow region, while Group 2 included patients from the Kamchatka region. Comprehensive assessments, including cardiovascular ultra-sound, Systematic Coronary Risk Evaluation (SCORE 2 2), and the Framingham Risk Scale, were conducted for all participants. Statistical analyses included descriptive statistics, Student's t-test for comparing means, Mann-Whitney U test for non-parametric data, and Pearson and Spearman correlation analyses. P-values were calculated to assess statistical significance, with a threshold set at P < 0.05.
Results:
Notably, 49% of patients residing in the subarctic region exhibited an inadequate nocturnal BP reduction (<10%). These non-dipping ABPM patterns were associated with increased diastolic BP variability and elevated Double Product (systolic BP x heart rate) compared to those with normal dipping. Furthermore, the non-dipping ABPM pattern observed in subarctic region residents demonstrated notable correlations with cardiovascular risk factors.
Conclusions:
The study reveals that patients in the subarctic region exhibit a higher prevalence of non-dipping blood pressure patterns, which is associated with increased diastolic blood pressure variability, higher nighttime blood pressure levels, and a greater incidence of left ventricular hypertrophy. These findings highlight the need for tailored diagnostic and treatment approaches to address the unique cardiovascular risks associated with different climatic conditions.
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