Autonomic regulation disorders in elderly patients with arterial hypertension and post-covid syndrome

Post-COVID syndrome in elderly patients with arterial hypertension remains insufficiently studied, particularly in terms of autonomic dysfunction. The systemic effects of SARS-CoV-2 and its influence on cardiovascular regulation make the identification of such disorders a relevant issue in modern medicine.

Objective of the Study. To investigate autonomic nervous system dysfunction in elderly patients with arterial hypertension and post-COVID syndrome.

Materials and мethods. As part of outpatient follow-up at the clinical bases of the Kazakhstan Russian Medical University, a study was conducted to assess autonomic dysfunction in elderly patients with arterial hypertension and post-COVID syndrome. The examination included interviews, physical examinations, and assessment using Wayne’s scale, and heart rate variability analysis using the «CardioVisor» module. Time and frequency domain parameters were evaluated: SDNN, rMSSD, pNN50, LF, HF, LF/HF, the stress index, and the regulatory systems activity index.

Results. The study included 141 patients divided into two groups. The mean age in the main group was 70.81 ± 5.36 years, compared to 74.00 ± 6.06 years in the control group (p = 0.003). The proportion of patients aged 60-74 years was higher in the main group (p = 0.006). Grade 1 arterial hypertension was more common in patients with post-COVID syndrome, while grades 2 and 3 were more frequent in the control group (p = 0.042). Patients with post-COVID syndrome more often reported fatigue (38.36 %), anxiety (19.18 %), memory impairment (21.92 %), and excessive sweating (26.03 %) (p ≤ 0.001). According to the Wayne scale, respiratory symptoms were more prevalent during emotional stress (p = 0.014). Among heart rate variability indicators, a significant difference was observed in the LF/HF ratio (1.8 vs 1.5; p = 0.049).

Conclusion. In elderly patients with arterial hypertension, post-COVID syndrome is accompanied by characteristic complaints and signs of autonomic dysfunction, highlighting the need for further investigation into its impact on chronic conditions.

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