Hypertensive crisis as cerebrovascular disease risk factor

Objective. To assess main epidemiological indicators for hypertensive crises (HC) in the population of productive age and to study possible correlations of crisis associated arterial hypertension (AH) with clinical and instrumental phenomenon of chronic cerebrovascular diseases. Materials and methods. Data of several studies presented: cross-sectional studies of 726 people aged 35-64 and 415 people aged 40-59. Observational cohort study of 109 patients aged 57.4±5.8 with uncomplicated AH. For the detection of HC in anamnesis, there were used special criteria which widens standard HC definition for additional account of light and mild severity cases. Results. Overall AH prevalence was 45% (95% CI 41-51), in men - 48% (40.2-55.9), in women - 45% (38.4-51.6). History of HC in anamnesis was 11.8% (95% CI 9-15.2), in men 8.8% (5.4-14) and in women - 13.8% (10-18.7). Proportion of HC associated AH defined at the level of 25-30% of all AH cases. The most prevalence of HC associated AH was found in people with “high normal” (130-139/85-89) arterial pressure - 37%. Prevalence of the complaints on headaches, dizziness, poor memory and lower intellectual productivity was higher in people with HC. Chronic cerebrovascular disease was found 2-fold frequently in HC associated AH. But in generally analysis of possible correlations of HC with clinical and instrumental phenomenon of chronic cerebrovascular diseases didn’t revealed any statistically significant differences. Conclusion. HC burden for healthcare system is serious, because it is important risk factor for cerebrovascular diseases and associated with significant lowering of the quality of life. Prevalence of the HC cases with light and mild severity is underestimated. Despite that the study of the most prevalent forms of HC (rare, light and mild severity) didn’t find any associations with morphological or persistent clinical pathology, functional phenomenon were found statistically significant frequently.

hypertensive crisis, stroke, risk factors, epidemiology, cerebrovascular disease

1. Feigin V.L, Roth G.A, Naghavi M et al. Global burden of stroke and risk factors in 188 countries, during 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet Neurol 2016; 15 (9): 913-24.

2. Chobanian A.V, Bakris G.L, Black H.R et al. Seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure. Hypertension 2003; 42 (6): 1206-52.

3. Mancia G, De Backer G, Dominiczak A et al. 2007 Guidelines for the Management of Arterial Hypertension: The Task Force for the Management of Arterial Hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC). J Hypertens 2007; 25 (6): 1105-87.

4. Lerario M.P, Merkler A.E, Gialdini G et al. Risk of Stroke After the International Classification of Diseases-Ninth Revision Discharge Code Diagnosis of Hypertensive Encephalopathy. Stroke 2016; 47 (2): 372-5.

5. Прокопович М.Е., Варакин Ю.Я., Ощепкова Е.В. и др. Прогностические факторы развития острых нарушений мозгового кровообращения при гипертонической болезни. Терапевт. архив. 2006; 78 (10): 14-8.

6. Щелчкова И.С. Эпидемиология инсульта в городе Краснодаре (по данным регистра). Автореф. дис. … канд. мед. наук. М., 2001.

7. Улимбашева Э.С. Клинико-эпидемиологическое исследование повторных инсультов при артериалной гипертонии (регистр инсульта в городе Нальчике). Автореф. дис. … канд. мед. наук. М., 2007.

8. Котова Е.Ю. Клинико-эпидемиологическая характеристика, ведущие факторы риска, характер течения инсульта в г. Ульяновске (по данным Регистра инсульта). Автореф. дис. … канд. мед. наук. М., 2009.

9. Олейников В.Г. Заболеваемость преходящими нарушениями мозгового кровообращения в группах мужчин среднего возраста: связь с факторами риска и патологией магистральных артерий головы. Автореф. дис. … канд. мед. наук. М., 1990.

10. Фейгин В.Л. Эпидемиология и профилактика цереброваскулярных заболеваний в условиях Сибири. Автореф. дис. … д-ра мед. наук. М., 1991.

11. Гапонова Н.И., Плавунов Н.Ф., Бараташвили В.Л. Клинико-статистический анализ артериальной гипертензии, осложненной гипертоническим кризом, в Москве за 2005-2009 гг. Кардиология. 2011; 51 (2): 40-4.

12. Janke A.T, McNaughton C.D, Brody A.M et al. Trends in the Incidence of Hypertensive Emergencies in US Emergency Departments From 2006 to 2013. J Am Heart Assoc 2016; 5 (12).

13. Zampaglione B, Pascale C, Marchisio M et al. Hypertensive urgencies and emergencies. Prevalence and clinical presentation. Hypertension 1996; 27 (1): 144-7.

14. Papadopoulos D.P, Mourouzis I, Thomopoulos C и др. Hypertension crisis. Blood Press 2010; 19 (6): 328-36.

15. Manning L, Robinson T.G, Anderson C.S. Control of blood pressure in hypertensive neurological emergencies. Curr Hypertens Rep 2014; 16 (6): 436.

16. Колтовер А.Н., Верещагин Н.В., Людковская И.Г. и др. Патологическая анатомия нарушений мозгового кровообращения. М.: Медицина, 1975.]

17. Ганнушкина И.В. Физиология и патофизиология мозгового кровообращения. В кн.: Сосудистые заболевания нервной системы. Под ред. Е.В.Шмидта. М.: Медицина, 1975; с. 65-105

18. Ганнушкина И.В. Патофизиология нарушений мозгового кровообращения. В кн.: Очерки ангионеврологии. Под ред. З.А.Суслиной. М.: Атмосфера, 2005; с. 17-40