Optimising the Timing of Health Resort Treatment in Patients with Arterial Hypertension and Increased Meteosensitivity: a Prospective Study

INTRODUCTION. Arterial hypertension (AH) is a socially significant disease. A significant proportion of patients with AH are weather-sensitive, which significantly aggravates the course of the underlying disease. AIM. To develop programs for restoring the functional state and adaptive capabilities of patients with arterial hypertension and increased weather sensitivity in order to optimize the duration of their spa treatment. MATERIALS AND METHODS. An observational prospective clinical comparative study of 129 patients aged 62 [56; 68] years was conducted for 12 days. The patients were divided into 3 groups. All patients received general sodium chloride baths, gas-air carbon dioxide baths, parafango applications, hyperbaric oxygenation, therapeutic exercises, cognitive-behavioral therapy, and continuous hypotensive drug therapy. Additionally, the first group of patients received dosed aerotherapy together with therapeutic exercises, and the second group received paradoxical breathing exercises using the Strelnikova method. Before and after the course of treatment, anthropometry, peripheral hemodynamics, heart rate variability, and the psychophysiological state of the patients were assessed. RESULTS AND DISCUSSION. After completion of treatment, statistically significant differences were obtained in all groups of patients in terms of a decrease in systolic blood pressure (SBP) and an increase in the Well-Being scale scores of the SAN test (according to the Wilcoxon test, p 0.05). In the first group of patients, after treatment, a statistically significant decrease in elevated pulse pressure, heart rate (HR), integral and frequency indices of heart rate variability (RMSSD, SDNN, LW, IN, PARS) was observed (according to the Wilcoxon test, p 0.05). Statistically significant differences were revealed between the first and third groups in the level of reduction of initially elevated systolic (U = 54.0, p = 0.02) and pulse BP (U = 55.5, p = 0.023), HR (U = 56.0, p = 0.037), RMSSD, SDNN, LW, IN, PARS (U = 13.0, p = 0.048; U = 34.2, p = 0.033; U = 13.0, p = 0.048; U = 0.0, p = 0.02; U = 48.0, p = 0.033, respectively), and the Well-Being scale of the SAN questionnaire (U = 50.0, p = 0.043). CONCLUSION. The study has shown the effectiveness of non-drug treatment programme for AH with increased meteosensitivity, including procedures of aerotherapy and exercise therapy, allowing to optimize the terms of health-resort treatment.