Evaluation of the functional state of pediatric patients with primary arterial hypertension

Introduction. Evaluation of the impact of arterial hypertension (AH) on the adaptation of school-age patients, the relationship with anthropometric indicators and physical condition is an important aspect in medical practice.

Aim. To identify the relationship between the level of physical condition and the level of regulatory-adaptive capabilities in pediatric patients with primary AH.

Materials and methods. A single-center observational cross-sectional comparative study was conducted involving 96 pediatric patients aged 8 to 17 years, hospitalized with a diagnosis of primary AH. The level of physical condition was determined using the formula of E.A. Pirogova and the level of regulatory-adaptive capabilities using the formula of V.M. Pokrovsky, taking into account the parameters of cardiorespiratory synchronism obtained using the VNS-Micro device and special software.

Results. Comparative analysis showed that the level of physical condition in girls and boys with primary AH did not differ significantly, with low and “below average” levels prevailing, while the value of the regulatory-adaptive status index in girls (22.30 ± 20.06, M ± SD) was significantly lower than in boys (33.27 ± 16.80; p = 0.01). A high level of regulatory-adaptive capabilities was not observed in pediatric patients with primary AH. Correlation analysis revealed a moderate positive relationship between the heart rate and the regulatory-adaptive status index in girls. There was no correlation between the level of physical condition and the level of regulatory-adaptive capabilities; there was a tendency toward a weak negative relationship in the group of girls.

Conclusions. Given the lack of a clear connection between the levels of physical condition and regulatory-adaptive capabilities, additional assessment of the functional state of pediatric patients with primary AH using the cardiorespiratory synchronism test can be used to characterize the adaptation of children with a low level of physical condition. At the same time, the development and nature of the leading adaptation mechanisms in girls and boys with primary AH may differ.

1. Lee J, Cha S, Lee J, Kim S, Song Y. Association between Obesity and Cardiovascular Disease Risk Factors in Different Age Groups of Adolescents: An Analysis of Data from the Korean National Health and Nutritional Examination Survey. Children. 2023;10(5):827. https://doi.org/10.3390/children10050827.

2. Agapitov LI, Cherepnina IV. Diagnostics and treatment of arterial hypertension in children and adolescents, overview of new clinical guidelines of the American Academy of Pediatrics. Russian Bulletin of Perinatology and Pediatrics. 2019;64(4):114–127. (In Russ.) https://doi.org/10.21508/1027-4065-2019-64-4-114-127.

3. Балтина ТВ, Яфарова ГГ, Гиззатуллин АР, Звездочкина НВ. Практические работы по курсу «Биология человека». Часть 2. Здоровье человека: учебно-методическое пособие. Казань: Казанский федеральный университет; 2020. 76 с. Режим доступа: https://dspace.kpfu.ru/xmlui/handle/net/176132.

4. Покровский ВМ. Формирование ритма сердца в организме человека и животных. Краснодар: Кубань-Книга; 200. 144 с. Режим доступа: https://www.elibrary.ru/omulkp.

5. Pokrovskii VM, Abushkevich VG, Pohotko AG, Barbuhatti KO, Smolina EG, Maingart SV. Estimation of functional adaptation of the transplanted heart in an organism of the recipient. Kuban Scientific Medical Bulletin. 2014;(6):62–65. (In Russ.) Available at: https://ksma.elpub.ru/jour/article/view/241.

6. Покровский ВМ, Абушкевич ВГ, Горбунов РВ, Компаниец ОГ, Куценко ИИ, Лазарева ЛА и др. Сердечно-дыхательный синхронизм в оценке регуляторно-адаптивных возможностей организма. Краснодар: Кубань-книга; 2010. 244 с. Режим доступа: https://www.elibrary.ru/qlykpd.

7. Galustyan MZ, Kutsenko II. The evaluation of the regulatory and adaptive abilities of an organism of the pregnant women to determine the readiness of an organism for delivery. Kuban Scientific Medical Bulletin. 2006;(9):96–102. (In Russ.) Available at: https://www.elibrary.ru/hvfwbx.

8. Pukhnyak DV, Mingalev AN, Abuschkevich VG. The evaluation of the increase of the level of stress resistance in parachutists, developing in the process of training. Fundamental Research. 2011;(5):154–158. (In Russ.) Available at: https://fundamental-research.ru/article/view?id=21276.

9. Burlutskaya AV. Cardiorespiratory synchronism test in complex diagnostics of sick sinus syndrome in children. Clinical Physiology of Circulation. 2008;(3):24–27. Available at: https://cfc-journal.com/catalog/detail.php?SECTION_ID=916&ID=17134.

10. Полищук СВ, Полищук ЛВ. Стрессоустойчивость студентов к экзаменационному стрессу. В: Материалы XXIII съезда Физиологического общества им. И.П. Павлова с международным участием. Воронеж, 18–22 сентября 2017 г. Воронеж: Истоки; 2017. С. 1480–1481. Режим доступа: https://www.elibrary.ru/xxzhwp.

11. Muntyan IM, Polishchuk VV, Pokrovsky VM. Assessment of Stress Resistance of Divers Based on Cardiorespiratory Synchronism Data. Human. Sport. Medicine. 2020;20(4):48–54. (In Russ.) Available at: https://www.elibrary.ru/yadign.

12. Potyagailo EG, Pokrovsky VM. New ways of psychoemotional distress diagnosis in children. Pediatriya – Zhurnal im G.N. Speranskogo. 2004;83(5):54–55. (In Russ.) Available at: https://pediatriajournal.ru/archive?show=275&section=1634

13. Potyagailo EG, Dremlyugova AF. Cardio-respiratory synchronism in evaluation of adaptive status in children with functional and organic pathology of the stomach. Bulletin Physiology and Pathology of Respiration. 2011;(41):25–28. (In Russ.) Available at: https://cfpd.elpub.ru/jour/article/view/404.

14. Shiykha JuG. Nfluence of orthodontic treatment on psycho emotional status and regulative and adaptive abilities of an organism of children with malocclusion. Kuban Scientific Medical Bulletin. 2006;(1-2):115–119. (In Russ.) Available at: https://www.elibrary.ru/hujizz.

15. Blinkov SN, Bashmak AF, Mezentseva VA, Borodacheva SE. Research of physical state and physical health of female students. Uchenye Zpiski Universiteta imeni P.F. Lesgafta. 2018;(10):38–43. (In Russ.) Available at: https://www.elibrary.ru/ynfuvn.

16. Полищук ВВ, Шкиря ТВ, Покровский ВМ. Система для одновременного определения сердечно-дыхательного синхронизма и вегетативного индекса у человека. Патент RU 201589 U1, 22.12.2020. Режим доступа: https://www.elibrary.ru/luxoha.

17. Шкиря ТВ, Усатиков СВ, Покровский ВМ, Полищук ЛВ. Программа для экспресс-диагностики уровня регуляторно-адаптивного статуса организма в системе определения сердечно-дыхательного синхронизма человека. Свидетельство о государственной регистрации RU 2015660661, 05.10.2015. Режим доступа: https://www.elibrary.ru/oruqzi.

18. Полищук ВВ, Шкиря ТВ, Полищук СВ, Покровский ВМ. Программа для определения параметров сердечно-дыхательного синхронизма у человека. Свидетельство о государственной регистрации RU 2021611568, 01.02.2021. Режим доступа: https://www.elibrary.ru/lbdduq.

19. Pokrovskii VM, Polischuk VV. The influence of the precision of the set respiratory rhythm reproduction on the parameters of cardiorespiratory synchronism. Medical News of North Caucasus. 2021;16(1):68–70. (In Russ.) https://doi.org/10.14300/mnnc.2021.16018.

20. Polishchuk VV, Chelyadinova MA, Gubaydullin TR. Optimization of reproducing the set breathing rhythm during a cardiorespiratory synchronism test. Journal of Medical and Biological Research. 2021;9(1):45–50. (In Russ.) https://doi.org/10.37482/2687-1491-z042.

21. Pankova NB, Alchinova IB, Cherepov AB, Buinov RP, Karganov MYu. Features of the reactivity of the cardiovascular and respiratory systems of the human body in stress tests in different climatic conditions and in the dynamics of adaptation to Northern conditions. Pathogenesis. 2023;21(1):69–74. (In Russ.) Available at: https://pathogenesis.pro/article/view/601.

22. Polischuk VV, Pokrovsky VM, Polischuk LV, Potapenko VK. Analysis of the conscious control of the human heart rhythm phenomenon. Kuban Scientific Medical Bulletin. 2013;(1):140–142. (In Russ.) Available at: https://www.elibrary.ru/qccqip.

23. Емелина АА. Особенности артериального давления и диагностики артериальной гипертензии у детей с отклонениями физического развития. В: Котельников ГП, Крюков НН, Щукин ЮВ, Федорина ТА, Колсанов АВ, Куркин ВА и др. (ред.). Аспирантские чтения – 2012: материалы докладов Всероссийской конференции с международным участием «Молодые учёные – медицине», Самара, 23 октября 2012 г. Самара: Книга; 2012. С. 173–175. Режим доступа: https://www.elibrary.ru/uxiqjn.

24. Aleksanyants GD. Use of phenomenon of cardiorespiratory synchronism for estimation of regulative-adaptive opportunities of organism of young athletes. Teoriya i Pracktika Fizicheskoy Kultury. 2004;(8):25–26. (In Russ.) Available at: http://lib.sportedu.ru/Press/TPFK/2004N8/p25-26,39.htm.

25. Kashina YuV, Cherednik IL, Pokrovskii VM, Polischuk VV, Shakhanova AV. Dynamics of the psychological status of medical university students. Psychophysiology News. 2024;(3):43–50. https://doi.org/10.34985/m2920-7474-2332-k.