rpcardioRational Pharmacotherapy in CardiologyРациональная Фармакотерапия в Кардиологии1819-64462225-3653«SILICEA-POLIGRAF» LLC10.20996/1819-6446-2021-06-13rpcardio-2511Research ArticlePOINT OF VIEWТОЧКА ЗРЕНИЯThe “Inverse” Seasonal Blood Pressure Variability PhenotypeФенотип «инвертированной» сезонной вариабельности артериального давленияhttps://orcid.org/0000-0001-5195-8997ГорбуновВ. М.GorbunovV. M.

Горбунов Владимир Михайлович – eLibrary SPIN 5111-1303

Москва

Vladimir M. Gorbunov - eLibrary SPIN 5111-1303

Moscow

https://orcid.org/0000-0002-6208-3038СмирноваМ. М.SmirnovaM. I.

Смирнова Марина Игоревна

Москва

Marina I. Smirnova

Moscow

https://orcid.org/0000-0001-5187-6190КошеляевскаяЯ. Н.KoshelyaevskayaY. N.

Кошеляевская Яна Николаевна – eLibrary SPIN 8660-0502

Москва

Yana N. Koshelyaevskaya - eLibrary SPIN 8660-0502

Moscow

ПануеваН. Н.PanuevaN. N.

Пануева Наталья Николаевна – eLibrary SPIN 4098-3522

Natalya N. Panueva - eLibrary SPIN 4098-3522

https://orcid.org/0000-0002-5686-6431ФурманН. В.FurmanN. V.

Фурман Николай Викторович

Nikolai V. Furman

https://orcid.org/0000-0002-7515-1722ДолотовскаяП. В.DolotovskayaP. V.

Долотовская Полина Владимировна – eLibrary SPIN 8240-2328

Polina V. Dolotovskaya - eLibrary SPIN 8240-2328

Национальный медицинский исследовательский центр терапии и профилактической медициныРоссияNational Medical Research Center for Therapy and Preventive MedicineRussian FederationИвановская государственная медицинская академияРоссияIvanovo State Medical AcademyRussian FederationСаратовский государственный медицинский университет им. В.И. РазумовскогоРоссияSaratov State Medical University named after V.I. RazumovskyRussian Federation202112072021173470475Copyright © Gorbunov V.M., Smirnova M.I., Koshelyaevskaya Y.N., Panueva N.N., Furman N.V., Dolotovskaya P.V., 20212021Горбунов В.М., Смирнова М.М., Кошеляевская Я.Н., Пануева Н.Н., Фурман Н.В., Долотовская П.В.Gorbunov V.M., Smirnova M.I., Koshelyaevskaya Y.N., Panueva N.N., Furman N.V., Dolotovskaya P.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.rpcardio.online/jour/article/view/2511

The seasonal blood pressure variability (BPV) is known to demonstrate a typical winter peak. Recently, more attention is paid to the opposite situation: the summer BP levels being higher than those in winter. This phenomenon is called inverse BPV. The present article summarizes recent data on this topic. The data of the HOMED-BP project, as well as the results of the original prospective study in 770 hypertensive patients from two Russian Federation regions (mean follow-up duration 6.4 years), were used. According to the preliminary knowledge, the prevalence of inverse BPV in hypertensive patients is relatively high (15-25%). This phenomenon is more typical for treated patients, particularly for those on combination therapy, and is associated with beta-blocker intake. Higher duration of hypertension and higher levels of some risk factors (smoking) characterize the patients with inverse BPV. According to the HOMED-BP data, patients with inverse BPV had the highest overall cardiovascular risk (hazard ratio in comparison with the reference group of “minimal” “normal” BPV was 3.07; p=0.004). In summary, inverse BPV is a potentially unfavorable BP phenotype. However, its reproducibility and prospective value deserve further investigation. The absolute magnitude of seasonal BPV in these patients, calculated using different BP measurement methods, warrants special attention.

Сезонная вариабельность артериального давления (АД), как правило, характеризуется типичным подъемом в зимний период. В последнее время определенное внимание уделяется обратной ситуации: летней уровень АД превышает зимний. Этот феномен получил наименование «инвертированная вариабельность артериального давления» (ИВАД). В статье обобщена имеющаяся на текущий момент информация по проблеме. Материалом послужили данные проекта HOMED-BP, а также собственное проспективное исследование авторов, в котором 770 пациентов с артериальной гипертензией (АГ) из двух регионов Российской Федерации наблюдались в среднем 6,4 года. Согласно предварительным данным, ИВАД является распространенным феноменом и может наблюдаться у 15-25% больных АГ. Данный феномен наиболее часто встречается у пациентов, уже получающих длительную антигипертензивную терапию, в том числе, комбинированную; ассоциирован с приемом бета-адреноблокаторов. У пациентов с ИВАД по сравнению с пациентами с «нормальной» сезонной ВАД более длителен «стаж» АГ, более выражены некоторые факторы риска (курение). По данным исследования HOMED-BP у пациентов с ИВАД был отмечен наибольший риск сердечно-сосудистых осложнений (отношение рисков относительно референсной группы с «малой» «нормальной» сезонной ВАД составила 3,07; p=0,004). Таким образом, ИВАД является потенциально неблагоприятным фенотипом АД. Однако его воспроизводимость и прогностическое значение нуждаются в дальнейшем изучении. Особого внимания заслуживают индивидуальные характеристики пациентов с ИВАД, в частности, абсолютная величина сезонных колебаний АД при использовании различных методов измерения.

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The authors declare that there are no conflicts of interest present.