Hemodynamic Disorder in Students with Vegeto-Vascular Dystonia

Фотографии: 

G.M. Kazantinova, professor, Dr.Med.
T.N. Vlasova, associate professor, Ph.D.
Volgograd state agrarian university, Volgograd

Key words: hemodynamics, vegeto-vascular dystonia, physical education.

Introduction. According to numerous studies, cardiovascular diseases are primary in the structure of the common sickness rate [6, 9]. Functional diseases take an essential part in the structure of the pathology of this system [5, 7], which is proved by the assessed sickness rate among university students [4, 2, 8]. Meanwhile, the capacities of muscular activity relate to the cardiovascular system in many ways, which is an essential oxygen limiting system along with the respiratory apparatus [10].

The purpose of the study was to examine the state of hemodynamics in students of the specialized department suffering from vegeto-vascular dystonia and to apply the findings in the courseware for physical education classes.

Materials and methods. The state of hemodynamics was assessed by heart rate (HR), blood pressure indicators - systolic (SBP) and diastolic (DBP), which were determined using the electronic device A and D (Japan), model IA-777. They underlied the calculations of: pulse blood pressure (PBP) and average hemodynamic (Av). Stroke output (SO) was defined by the Starr’s formula and total peripheral resistance (TPR) – using the N. Savitsky’s formula [1]. Cardiac output (CO) was assessed by multiplying the SO of the blood by HR per minute. Coefficients of efficiency of blood circulation (CEC) and endurance factor (EF) were used to assess the functional status of the cardiovascular system [3]. The studies were conducted during the morning classes (1st two classes) after a 10-15-minute rest.

222 first-year students (46.8% young males and 53.2 % females) were subject to examination. In the medical examination VVD was diagnosed in 33.6 % of boys and 45.8% girls. 24% of boys and 13,6% girls belong to hypertensive type, 9,6% of boys and 20% of girls – to mixed one. The hypotonic and cardiac types of VVD were diagnosed only in girls, 9.3 and 5.9 % respectively.

Results and discussion. Proceeding from the studies, HR of the majority of students is accelerated and more markedly pronounced in girls with the hypertensive and cardiac types of VVD (Tab. 1).

Table 1. Heart rate and blood pressure indicators

Indices of hemodynamics

Type of VVD

Control group

Hypertensive,

n=25/12

Hypotonic, n=0/15

Cardiac, n=0/17

Mixed, n=10/20

HR, min

88±2,85

92±4,15*

-

-

84±3,78

83±1,91

81±3,3

77±3,4

74±2,55

92±4,68*

SBP, mm Hg

143±1,91*

137±1,68***

-

-

134±3,47

116±1,17

129±5,5

112±2,4

98±1,92***

116±1,79

DBP, mm Hg

80±1,75*

80±2,13***

-

-

73±3,08

70±1,43

73±2,0

65±2,3

62±1,57

74±1,91***

PBP, mm Hg

63±2,30***

55±2,29***

-

-

61±2,16

45±1,85

54±2,7

46±2,0

36±1,19***

42±2,01

Av, mm Hg

111±1,39***

103±2,88***

-

-

104±3,03

95±1,51*

100±2,3

88±2,2

80±1,60***

94±1,94

Note. Here and in Table 2: numerator - data of boys, denominator - girls;

*** - significant when compared with the control group at p <0,05, p <0,001.

The systolic blood pressure level was determined increased in students of three types of VVD, but more clearly – in boys and girls with the hypertensive type of VVD, amounting 143 ± 1,91 mm Hg (p<0,05) and 137 ± 1,68 mm Hg (p<0,001) on the average. In the girls with the hypotonic type of VVD its level reached only 98 ± 1,92 mm Hg (p<0,001). A similar trend was noted when estimating the index of diastolic blood pressure. Pulse blood pressure was significantly elevated in boys and girls with the hypertensive type of VVD. The one of the girls with the hypotonic and cardiac types was reduced, which was particularly noticeable in the former, reaching 36 ± 1,19 mm Hg (p<0,001) on average. Average blood pressure was recorded elevated in students with hypertensive, cardiac and mixed types of VVD and its level was significantly elevated in girls and boys with the hypertensive type and decreased in girls with the hypotonic one.

Table 2. Indices of cardiac output, total peripheral resistance and efficiency of work of cardiovascular system

Indices of hemodynamics

Тип of VVD

Control group

 

hypertensive

hypotonic

cardiac

mixed

SO, ml

75,7±2,55

70,1±2,22

-

-

74,9±2,31

69,8±1,49

71,7±3,4

72,5±1,6

70,9±1,15

66,2±1,95*

CO, l/min

6,7±0,27

6,2±0,32

-

-

6,3±0,27

5,8±0,22

5,9±0,5

5,6±0,2

5,2±0,19

6,1±0,45

TPR, dyne.sec/cm3

1414±67

1393±78

-

-

1345±62

1315±52

1335±60

1256±52

1245±52

1298±116

CEC, c.u.

5554±223***

4843±291***

-

-

5159±300***

3809±126***

2600±190

2400±200

2690±123

3960±342***

EF, c.u.

14,8±0,87

16,5±1,05

-

-

13,9±0,81

18,8±0,70***

16±0,7

15±0,6

20,4±1,02**

21,7±0,90***

The analysis of the indicators of cardiac output of the blood showed a moderate upward trend of stroke output and cardiac output in boys with the hypertensive and mixed types of VVD, and the downward trend in the girls with the hypotonic type.

The data of total peripheral resistance showed the same direction as the cardiac output. A more noticeable trend towards its increase was observed in boys and girls with the hypertensive type of VVD, averaging 1414 ± 67 and 1393±78 dyne.sec/cm3 respectively.

The coefficient of efficiency of blood circulation of boys and girls with all types of VVD was increased. Its highest indices were recorded in students with VVD of the hypertensive and mixed types. The endurance coefficient was defined as slightly reduced in boys with the hypertensive and mixed types of VVD and increased in girls with all types of VVD, especially with the hypotonic and cardiac ones, amounting to 20,4 ± 1,02 c.u. (p <0,001) and 21,7 ± 0,96 c.u. (p <0,001) on the average.

Thus, the studies have established hemodynamic disorders and their nature in students with vegeto-vascular dystonia. Primarily they are displayed in the change of the blood pressure level, directly dependent on the type of vegeto-vascular dystonia. It should be emphasized that despite the functional nature of the disease hypertension in boys and girls with vegeto-vascular dystonia of the hypertensive type is of systolic-diastolic nature. This feature of the nature of hypertension combined with the elevated level of average hemodynamic blood pressure gives grounds to consider these persons as a risk group regarding hypertensive disease. The latter requires the dynamic monitoring of the blood pressure level during physical exercises.

It should be noted that despite the diverse changes in cardiac output it remains adequate to slightly increased or decreased total peripheral resistance. This hemodynamic “balance" is confirmed by the sufficient indices of the endurance factor. Moreover, high coefficient of efficiency of blood circulation indicates the hard work of the cardiovascular system. The differential estimate of the noted changes in hemodynamics of the surveyed students in view of the type of vegeto-vascular dystonia suggests that the course of the disease is prognostically more unfavorable in persons with the hypertensive type of vegeto-vascular dystonia.

Proceeding from the principle of the nosological distribution of students into groups at sports classes, performed strength, speed-strength exercises are assumed to be excluded or limited in accordance with individual characteristics of students’ vegeto-vascular dystonia of the hypertensive type. But this issue can be settled only within the framework of the individual approach.

Conclusions:

  • In students with vegeto-vascular dystonia hemodynamic disorders were proved to depend directly on its type.
  • The course of the disease is predictively more unfavorable for the students with vegeto-vascular dystonia of the hypertensive type.
  • The differentiated approach is required in correcting the volume of physical exercises and its type in the studied group in view of the vegeto-vascular dystonia. 

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Authors’ contacts: aleksandrik4@rambler.ru; Tatyanavlasova1@gmail.com