К.А. Bobryshev State of сentral haemodynamics in the different saltreactivity types of essential arterial hypertension.

The aim of the study was to determine central haemodynamic features in the different salt-reactivity types of essential arterial hypertension (EAH). We included 108 patients with stage II EAH. To identify the blood pressure (BP) salt-reactivity types we used dietary protocol. Plasma volume (PV) has been examined with glycaemic and postural tests, sodium taste threshold. Stroke volume was studied with echocardiography. Cardiac index and total peripheral resistance (TPR) were calculated. The patients were classified as salt-resistant (n=48), saltsensitive (n=41) and «paradoxical reactive» (n=19) ones. Salt-resistant patients had increased TPR under both low- and high-salt diet. Latter mildly increased PV and caused appropriate vasodilation without significant BP shift. In salt-sensitive patients central haemodynamic features at low-salt diet were similar to those in saltresistant ones, whereas high-salt diet caused hypervolemia – absolute and relative (because of insufficient vasodilation) with hypertensive reaction. In «paradoxical reactive» hypertensives low-salt diet induced absolute hypervolaemia, excess of vasoconstriction, and increased BP. High-salt diet restored PV partly, led to vasodilation, removed relative hypervolaemia, and caused BP reduction.

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