ISH ADA-05 THE NEW TECHNOLOGY AND CLASSIFICATION FOR THE ARTERIES REACTIVITY IN PATIENTS WITH HYPERTENSION.

OBJECTIVE: The aim of the study was to develop the new technology and to classify changes of arterial reactivity (AR) after metabolic stress tests in patients with hypertension.

DESIGN AND METHOD: All participants of research have given the informed agreement. We used new special portative apparatus with metering rate during hypercapnia (inhalation 2 min 4% mixture of carbonic gas with air (gipercapnia) or hyperoxia - 100% oxygen (giperoxia) and in periods of recovery (rec) (air-inhalation 2 min) of 264 patients (age 52.9 ± 12.9years) with essentially hypertension. We used ultrasonography of transcranial Doppler's method in the middle cerebral arteries (MCA). Determinacy arterial reaction is achieved by using the original device, it have low resistance of the respiratory system, the minimum volume of "dead" area, stable concentration of the gas mixture. We used Indexes of the flow velocity mean (FVm); IFVm = (Vm0-Vm)/Vm0*100, Speed Modification of FVm: SM = (Vm-Vm0)/120, Index of Recovery of FVm: IR = Vm0/Vmrec and new coefficient NBPA = (V2-V0)/(V0*(BP2-BP0)):Vm0 is starting and Vm is the parameters at period of inhalation, Vmrec is Vm after 120 sec.

RESULTS: New classification: patients with hypertension had 3 types of BAR hyperoxia-reactions (mean ± SD/incidence): patients have normal IFVm ≤ -20% (-26.6 ± 2.8%/2.4%), abnormal reduced -20% < IFVm < 0% (-10.2 ± 3.9%/22.4%), abnormal opposite IFVm≥0% (10.2 ± 2.5/76.2%); and 3 types of hypercapnia-reactions: normal 50% < IFVm < 70% (56.1 ± 6.1)/24.3%,), abnormal reduced IFVm < 50% (24.6 ± 9.8/96.7%,), abnormal enhanced IFVm > 70% (64.9 ± 5.1)/7.0%); 2 types of speed-reactions for hyperoxia: normal (SM ≤ -0.12) abnormal slow (SM > -0.12) and 3 types for hypercapnia: normal (0.25 ≤ SM ≤ 0.40), abnormal slow (SM < 0.25) and abnormal accelerated (SM FVm > 0.40); 2 types of recovery-reactions: normal recovery (Vmrec ≥ 1.0), abnormal slow recovery (Vmrec < 1.0).

CONCLUSIONS: The technology was developed to study AR and it's a quantitative estimation. Patients with hypertension have the different types and incidence reaction of AR after metabolic stress tests by reaction force, its speed of development and rate of recovery. AR can be classified by objective quantitative thresholds.