[Non-pharmacological correction of arterial pressure in hypertensive patients with a pacemaker].

Frequency-dependent hypotensive effect of cardiac pacing (CP) regarding type of circulation and stimulation regime under programmed changes of impulse frequency from 50 to 90 imp/min was studied in 92 patients (53 males, 39 females) with essential hypertension of the first, second and third degree and isolated systolic arterial hypertension. The rise of the above frequency over 80 imp/min was accompanied with a significant fall in systolic arterial pressure (SAP) in patients with hyperkinetic circulation while heart rhythm under 60 imp/min resulted in a significant lowering of diastolic arterial pressure (DAP) in patients with eukinetic and hypokinetic type of circulation. In regime VVI both SAP and DAP lowering was more pronounced than in AAI regime. The most prominent hypotensive effect was seen in VVI-stimulation complicated by ventriculoatrial conduction. Reprogramming of impulse frequency normalized arterial pressure in 43.3% patients with hyperkinetic type of circulation. Thus, a frequency-dependent hypotensive effect of programmed CP can be used for non-pharmacological correction of arterial hypertension and optimization of effectiveness of anti-hypertensive treatment in paced patients.