Changes of indices of diurnal blood pressure monitoring under the influence of treatment in patients with essential hypertension complicated with hemorrhagic stroke after early recovery period

The aim — to compare the indices of diurnal blood pressure monitoring (DBPM) in patients with essential hypertension (EH) іn ≥ 6 months after hemorrhagic stroke (HS) before and after treatment with combination of amlodipine, valsartan, hydroclorothiazide (if necessary) and magnesium oxide monohydrate.Materials and methods. The main group included 33 patients, the comparison group comprised 13 persons. In the first group the office blood pressure (BP) was і 140/90 mm Hg, in the second one it was lower. The groups were matched by main indicators. DBPM was performed twice (before and after treatment) for the main group of patients, and once for the comparison group patients.Results and discussion. In the main group, before and after treatment the mean systolic blood pressure (SBP) was 110.1 ± 16.0 mm Hg and 102.3 ± 12.6 mm Hg, respectively, at daytime, 102.6 ± 17.3 and 83.9 ± 8.1 mm Hg at night, 109.7 ± 15.7 and 96.3 ± 11.9 mm Hg (p < 0.05) per day. The maximum SBP at daytime in the main group was higher before the treatment (169.3 ± 18.4 mm Hg, p < 0.05). The value of the standard deviation of SBP and pulse BP decreased after treatment (p < 0.05). The value of the mean real variability of SBP in the main group was 11.27 ± 2.73 mm Hg before treatment and 9.74 ± 1.84 mm Hg (p < 0.05) after it. Diurnal index of SBD in the main group was 4.95 ± 9.67 % before treatment and 11.44 ± 5.43 % after it.Conclusions. The treatment of patients with EH, who had suffered HS ≥ 6 months before and had office BP ≥ 140/90 mm Hg, with combination of amlodipine (daily dose 5 — 10 mg), valsartan (daily dose 80 — 160 mg), hydroclorothiazide (12.5 mg if necessary) on the basis of chronotherapy approach and magnesium oxide monohydrate (456 mg daily during 1 month period) permits achieving the control of BP according to DBPM data in 73 % of patients. This treatment also permits statistically significant decreasing of short‑term BP variability, in particular, the standard deviation in all time intervals and the average real variability of SBD.