[PP.28.02] CLINICAL PATHOGENIC ASPECTS OF BLOOD PRESSURE CHRONOSTRUCTURE IN THE CONDITIONS OF SHIFTWORK IN THE ARCTIC

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Abstract

Objective:

To study clinical differences of arterial hypertension, to conduct standard and cosinor-analysis of 24-hour blood pressure (BP) monitoring for chronobiological assessment of AH circadian rhythms in shift workers of the Arctic polar region and native residents of Tyumen city.

Design and method:

373 patients with AH stage I-II in the control group and 144 patients with AH stage I-II in the comparative group were examined and underwent 24-hour BP monitoring, echocardiography, brachiocephalic artery ultrasound, treadmill ergometer test, 24-hour ECG holter monitoring and biochemical blood test.

Results:

In the conditions of shiftwork in the Arctic clinical implications of AH were more evident and associated with structural heart alterations, high frequency of atherosclerosis in brachiocephalic arteries, dislipidemy, low exercise tolerance and level of adaptive potential. Being influenced by exogenic factors, BP neurohumoral regulation mechanisms undergo circadian reliant changes modulating BP daily rhythm. In northern citizens with AH circadian BP profile was associated with low circadian rhythm indices, high BP variability, mainly night hyperbaric overload that explains high frequency of AH circadian BP profile «non dipper» and «night peaker». Reduction of stability and rate of BP daily rhythms with significant differences of acrophases location shifted to the later hours was revealed. Results of Fourier spectral analysis confirm “decay” of BP circadian structure in the conditions of changed photoperiodism of the Extreme North to a wide range of ultradian rhythms and disturbances in the spectrum of daily systolic BP and diastolic BP.

Conclusions:

Chronobiological disturbances in AH circadian rhythm in the conditions of shiftwork was caused by the malfunction of correspondence in internal and external cueing of physiological processes (desynchronosis) influenced by the conditions of shiftwork.

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