Heterogeneity of the atherosclerotic process in systemic hypertension poorly controlled by drug treatment
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Subclinical arterial alterations in hypertension are linked to higher systolic blood pressure (BP), smoking, and blood glucose. These factors correlate with increased pulse wave velocity and atherosclerosis, indicating varied arterial damage patterns.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Subclinical arterial damage can precede overt cardiovascular events.
- Understanding arterial alterations in hypertension is crucial for risk stratification.
Purpose of the Study:
- To investigate subclinical arterial alterations in patients with poorly controlled hypertension.
- To identify factors associated with increased arterial stiffness and atherosclerosis.
Main Methods:
- Cross-sectional study of 85 hypertensive patients.
- Aortic pulse wave velocity (PWV) measurement.
- Ultrasonic examinations for arterial assessment.
- Comparison of patients with normal vs. abnormal PWV relative to age and diastolic blood pressure (BP).
Main Results:
- 48 patients (Group II) showed abnormal PWV, compared to 37 (Group I).
- Group II had higher systolic BP, pulse BP, and blood glucose levels; lower diastolic BP; and higher smoking rates.
- Group II exhibited a positive correlation between blood glucose and PWV, and a higher frequency of carotid artery stenosis and atherosclerotic lesions.
Conclusions:
- Arterial alterations in hypertension are heterogeneous.
- Systolic BP, cigarette smoking, and blood glucose levels are implicated in these alterations.
- Elevated blood glucose is associated with increased arterial stiffness in hypertensive individuals.
Abstract:
A cross-sectional study of 85 patients with poorly controlled treated hypertension was performed to detect, by means of aortic pulse wave velocity measurement and ultrasonic examinations, subclinical alterations of arteries. Pulse wave velocity was related to the product of age and diastolic blood pressure (BP) according to a nomogram obtained from normotensive subjects, and was found inside the nomogram in 37 patients (group I) and outside in 48 (group II). Group II had higher systolic and pulse BP (p less than 0.01), lower diastolic BP (p less than 0.01), higher proportion of cigarette smokers (p less than 0.05) and higher blood glucose levels (p less than 0.02) than group I. In group II a positive correlation existed between blood glucose and pulse wave velocity (p less than 0.01). Group II had a higher frequency of carotid artery stenosis (p less than 0.05) and a trend toward increased frequency of aortic and lower limb atherosclerotic lesions. The results indicate a heterogeneous pattern of arterial alterations in which systolic BP, cigarette smoking and blood glucose level are implicated.