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[Arterial hypertension as a risk factor for multifocal atherosclerosis]
Mirza Dilić1, Akif Mlaćo, Bećir Heljić
1Institut za vaskularne bolesti, Klinicki centar Univerziteta u Sarajevu, Sarajevo, Bosna i Hercegovina.
Insights
This study found a strong link between multifocal atherosclerotic disease and multiple risk factors (MRF), particularly smoking and hypertension. These findings highlight the importance of managing these risk factors to prevent widespread atherosclerosis.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Context:
- Atherosclerosis is a systemic disease often presenting as multifocal arterial stenoses.
- Multiple Risk Factor (MRF) scores are known to correlate with atherosclerosis severity.
- Arterial hypertension is a significant independent risk factor for cardiovascular disease.
Purpose:
- To evaluate the prevalence of multifocal atherosclerotic disease in patients with arterial occlusive disease (AOD).
- To investigate the correlation between arterial hypertension and multifocal atherosclerotic disease.
- To assess the relationship between MRF scores and multifocal atherosclerotic disease.
Summary:
- The study included 109 patients with AOD, stratified by Fontaine clinical stage.
- Multifocal disease (AOD + Coronary Heart Disease and/or Cerebrovascular Disease) was present in 33.1% of patients.
- A significant positive correlation (r=0.70) was observed between multifocal disease, hypertension, and MRF score, with smoking being a high-risk factor (p<0.001).
Impact:
- Identifies smoking and hypertension as key factors associated with multifocal atherosclerotic disease.
- Provides evidence for the strong link between elevated MRF scores and the presence of multifocal atherosclerosis.
- Suggests the need for comprehensive risk factor management in patients with AOD to address multifocal disease progression.
Background:
It is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF). Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate the presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease.
Methods:
We included 109 consecutive patients treated at our Institute in the period Dec 1999--Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD, we made three groups--group FII, clinical stage Fontaine II 63 pts, group FIII, clinical stage Fontaine III 32 pts, and group FIV, clinical stage Fontaine IV 14 pts. We evaluated clinical variables: age, gender, arterial hypertension (HTA), tobacco, hyperlipidemia (HLP), obesity (BMI), diabetes mellitus, coronary heart disease (CHD), and cerebrovascular disease (CVD). Score of MRF is calculated as x/9. Special focus has been made to pts. with positive HTA. All pts. were evaluated according to clinical evidence of CHD and CVD, respectively.
Results:
We had 109 pts, 89 males and 20 females, average age of 62 yrs, males 63 and females 60 yrs. In the FII group were 63 pts. with average MRF 4.27, in the FIII group 32 pts. with MRF 3.97, in the FIV group 14 pts. with MRF 3.93. Out of the total number of pts. 52 were hypertensive (47.7%), 41 males, and 11 females, with average age 64.8 yrs, males, and 61.8 yrs, females. Isolated systolic HTA had 33 pts. (63.5%), and 19 pts. (36.5%) systolic and diastolic HTA. In whole group (n-109), multifocal disease, AOD + CHD, had 22 (20.21%) pts. (MRF score 4.86), AOD + CVD had (5.5%) 6 pts. (MRF score 3.66) and AOD + CHD + CVD had 8 (7.33%) patients (MRF score 6.13). In hypertensive pts. multifocal atherosclerotic disease, AOD + CHD, had 12 pts. (23.1%), and AOD + CHD + CVD, 2 pts (7.6%). Among clinical variables, tobacco was of high risk, 97 pts. positive (89.9%), what is of high significance, p < 0.001.
Conclusions:
We have a clear connection of multifocal disease with elevated MRF score, especially clinical variables, smoking (p < 0.001) and arterial hypertension (p < 0.01). Multifocal atherosclerotic disease was present in 36 pts. (33.1%), and among hypertensive pts. multifocal atherosclerotic disease was present in 14 pts. (26.9%). There is a high positive correlation rank of multifocal disease, HTA and score of MRF, r = .70, and borderline correlation rank of multifocal disease and score of MRF, r = .40.