VASCULAR AGE AND CARDIO-ANKLE VASCULAR INDEX IN PATIENTS WITH UNCONTROLLED ARTERIAL HYPERTENSON

Age is used in various algorithms to estimate cardiovascular risk. It is known that at the same age the health status of different patients can differ dramatically. The term vascular age (VA) was introduced in order to assess the severity of pathological process in the arterial wall. Arterial stiffness is most commonly used to estimate VA. The aim of our study was to investigate the arterial stiffness, VA in patients with uncontrolled and controlled course of arterial hypertension (AH), as well as to study the relationship between age, VA and markers of hypertension - mediated organ damage (HMOD). We put in our study 140 patients, including 80 patients with controlled course of hypertension (CH), 30 patients with uncontrolled course of hypertension (UH). 30 patients made up the control group. All groups were similar regarding age, sex, duration of hypertension and some biochemical characteristics. For all patients in our study the arterial stiffness, by means of cardio-ankle vascular index (CAVI), and VA were investigated, as well as the relationship between age, VA and markers of hypertension - mediated organ damage (HMOD) was studied. The average CAVI value in the CH group was 7,8±1,19, in the UH = 9,2+1,14, in the control group 7±0,64. The difference in CAVI values among all groups was significant (p<0,05). A positive correlation between CAVI and IMT, age and a negative correlation between CAVI and GFR was found in all three groups (p<0.05). A correlation was also found between CAVI and average daytime PBP (CH r=0.311; UH r=0, 484; p<0.05) and average night-time PBP (CH r=0.374, UN r=0.306, p<0.05) and with average night-time SBP in the group UH (r=0.349; p<0.05). VA (CH= 59[49;69], UH=71,5 [64;74], control group =54[44; 59] (p<0,05)) was significantly higher than the age of patients in the patients with AH, while in the control group no significant difference between ages was found. Significant positive correlation was found between VA and such markers of HMOD as IMT, ESV, GFR, LVPW thickness, IVS thickness. When VA was used instead of age, it was found that third of patients in CH and UH groups moved to the group of higher risk of cardiovascular (CV) events. The absence of antihypertensive therapy and target blood pressure values in patients lead to the progression of arterial stiffness and acceleration of VA in comparison to patients committed to the therapy. Use of VA in assessing the risk of CV events allows us to identify up to 30% of patients with an underestimated risk level.