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Coronary microvascular function in patients with isolated systolic and combined systolic/diastolic hypertension

Huseyin Bozbas1, Bahar Pirat, Aylin Yildirir

  • 1Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey. hbozbas@gmail.com

Journal of Clinical Hypertension (Greenwich, Conn.)
|December 5, 2012
PubMed

Insights

Isolated systolic hypertension (ISH) impairs coronary microvascular function more than combined systolic/diastolic hypertension (SDH). This study found lower coronary flow reserve (CFR) in ISH patients, indicating endothelial dysfunction.

Area of Science:

  • Cardiology
  • Geriatrics
  • Vascular Biology

Background:

  • Isolated systolic hypertension (ISH) is prevalent in the elderly and linked to endothelial dysfunction.
  • Coronary microvascular function is crucial for myocardial health, especially in hypertensive individuals.
  • Understanding hypertension's impact on coronary flow reserve (CFR) is vital for geriatric cardiovascular care.

Purpose of the Study:

  • To compare coronary flow reserve (CFR) in elderly patients with ISH versus combined systolic/diastolic hypertension (SDH).
  • To investigate the relationship between hypertension type and coronary microvascular endothelial function.
  • To identify predictors of impaired CFR in elderly hypertensive patients.

Main Methods:

  • Seventy-six elderly patients (>60 years) without coronary artery disease or diabetes were studied.
  • Patients were divided into two groups: 38 with ISH and 38 with SDH.
  • Coronary flow reserve (CFR) was assessed using transthoracic Doppler echocardiography, calculating the ratio of hyperemic to baseline diastolic peak flow velocities.

Main Results:

  • Patients with ISH exhibited significantly lower CFR values (2.22±0.51) compared to those with SDH (2.49±0.56), P=.03.
  • Multivariate analysis identified ISH (β=-0.40, P=.004) and dyslipidemia (β=-0.29, P=.04) as independent predictors of reduced CFR.
  • These findings suggest a more profound impairment of coronary microvascular/endothelial function in ISH.

Conclusions:

  • Coronary flow reserve is significantly reduced in elderly patients with isolated systolic hypertension compared to those with combined systolic/diastolic hypertension.
  • Isolated systolic hypertension is an independent predictor of impaired coronary microvascular function.
  • These results highlight the importance of assessing endothelial function in elderly patients with ISH.

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