Preview

Systemic Hypertension

Advanced search

Subclinical vessel lesion in normotensive patients with abdominal obesity: focus on arterial stiffness

Abstract

Aim: assessment of arterial stiffness (AS) in patients with abdominal obesity (AO) without arterial hypertension and low cardio-vascular risk (CVR), the analysis of AS correlation with the markers of target organ remodeling, determination of threshold values AS, combined with a high probability target organ damage. Subjects and methods. 95 normotensive patients with AO were examined (mean age 44,9±5,1 years, 72 men) by following methods: lipid and glucose level, carotid artery ultrasound with intima/media thickness estimation, echocardiography, 24-hour monitoring of blood pressure (BP) with arterial stiffness assessment, obtained by the portable recorder BPLab. Results. Subclinical arterial lesion was revealed in 37,9%, mean pulse wave velocity (PWV) was 7,6±0,6 m/s, maximum PWV – 10 m/s. PWV and central BP in aorta were higher in patients with subclinical carotid atherosclerosis (8,0±0,5 m/s vs 7,5±0,6 m/s, р<0,05), diastolic dysfunction (8,0±0,7 m/s vs 7,5±0,6 m/s, р<0,05), microalbuminuria (8,2±0,5 m/s vs 7,5±0,6 m/s, р<0,05). PWV≥8,3 m/s and average daily systolic BP in aorta ≥111 mm Hg correlated with subclinical target organ damage. Conclusion. The study of AS using a bifunctional 24-hour monitoring of BP may be a potentially simple and reproducible method for assessing the probability of the presence of subclinical atherosclerosis and high CVR, requiring no extra cost.

About the Authors

M. A. Druzhilov
Медико-санитарная часть УФСБ России по Республике Карелия
Russian Federation


V. V. Otmakhov
Медико-санитарная часть УФСБ России по Республике Карелия
Russian Federation


Yu. E. Beteleva
Медико-санитарная часть УФСБ России по Республике Карелия
Russian Federation


V. A. Korneva
ФГБОУ ВПО Петрозаводский государственный университет
Russian Federation


T. Yu. Kuznetsova
ФГБОУ ВПО Петрозаводский государственный университет
Russian Federation


References

1. Бойцов С.А., Карпов Ю.А., Кухарчук В.В. и др. Проблемы выявления лиц с высоким сердечно - сосудистым риском и возможные пути их решения. Атеросклероз и дислипидемии. 2010; 1 (1): 8–14.

2. Conroy R, Pyorala K, Fitzgerald A et al. Estimation of ten - year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24: 987–1003.

3. Assmann G, Cullen P, Schulte H. Simple scoring scheme for calculating the risk of acute coronary events based on the 10 – year follow - up of the prospective cardiovascular Munster (PROCAM) study. Circulation 2002; 105: 310–5.

4. De Ruijter W, Westendorp R, Assendelft W et al. Use of Framingham risk score and new biomarkers to predict cardiovascular mortality in older people: population based observational cohort study. Br Med J 2009; 338: a3083.

5. Laurent S, Cockcroft J, Van Bortel L et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. Eur Heart J 2006; 27: 2588–605.

6. Mancia G, Laurent S, Agabiti-Roseic E et al. Reappraisal of European guidelines on hypertension management: a European Society of Hypertension Task Force document. J Hypertens 2009; 27: 2121–58.

7. Рекомендации экспертов ВНОК по диагностике и лечению артериальной гипертензии (4-й пересмотр). Системные гипертензии. 2010; 3: 5–26.

8. Williams В, Lacy P. Central aortic pressure and clinical outcomes. J Hypertens 2009; 27: 1123–5.

9. Sehestedt T, Jeppesen J, Hansen T et al. Which markers of subclinical organ damage to measure in individuals with high normal blood pressure? J Hypertens 2009; 27: 1165–71.

10. Jankowski P, Kawecka-Jaszcz K, Czarnecka D et al. Aortic blood pressure and survival study group. Pulsatile but not steady component of blood pressure predicts cardiovascular events in coronary patients. J Hypertens 2008; 51: 848–55.

11. Wang K, Cheng H, Chuang S et al. Central or peripheral systolic or pulse pressure: which best relates to target organs and future mortality? J Hypertens 2009; 27:461–467.

12. Vergnaud A, Protogerou A, Blasher J et al. From «optimal» to «bordline» blood pressure in subjects under chronic antihypertensive therapy. J Hypertens 2008; 26 (1): 138–44.

13. Safar M, O'Rourke M. Handbook of hypertension, volume 23: arterial stiffness in hypertension. Elsevier, 2006.

14. Laurent S, Boutouyrie P. Recent advances in arterial stiffness and wave reflection in human hypertension: hypertension highlights. J Hypertens 2007; 49 1202–6.

15. Oren A, Vos L, Uiterwaal C et al. Aortic stiffness and carotid intimal - media thickness: two independent markers of subclinical vascular damage in young adults? Eur J Clin Invest 2003; 33: 949–54.

16. Рекомендации экспертов ВНОК по кардиоваскулярной профилактике. Кардиоваскулярная терапия и профилактика. 2011; 10 (6).

17. Pignoli P, Tremoli E, Poli A et al. Intimal plus medial thickness of the arterial wall: a direct measurements with ultrasound imaging. Circulation 1986; 74: 1399–406.

18. Моисеева Н.М., Пономарев Ю.А., Сергеева М.В. и др. Оценка показателей ригидности магистральных артерий по данным бифункционального суточного мониторирования АД и ЭКГ прибором BPLab. Артериальная гипертензия. 2007; 13 (1): 34–8.

19. Recommendations for Chamber Quantification: A Report from the American Society of chocardiography’s Guidelines and Standards Committee and the Chamber Quantification Writing Group, Developed in Conjunction with European Association of Echocardiography. J Am Soc Echocardiogr 2005; 18: 1446–7.

20. Safar M., Levy B, Struijker-Boudier H. Current Perspectives on Arterial Stiffness and Pulse Pressure in Hypertension and Cardiovascular Diseases. Circulation 2003; 107: 2864–9.

21. Laurent S, Boutouyrie P, Asmar R et al. Aortic stiffness is an independent predictor of all - cause and cardiovascular mortality in hypertensive patients. J Hypertens 2001; 37: 1236–41.

22. Sugawara J, Hayashi K, Yokoi T et al. Carotid–femoral pulse wave velocity: Impact of different arterial path length measurements. J Art Res 2010; 4: 27–31.

23. Wilkinson I. Artery Society guidelines for validation of non - invasive haemodynamic measurement devices. Part 1. Arterial pulse wave velocity. J Art Res 2010; 4: 34–40.

24. Mitchell G, Parise H, Benjamin E et al. Changes in arterial stiffness and wave reflection with advancing age in healthy men and women: the Framingham Heart Study. J Hypertens 2004; 43: 1239–45.

25. London G, Guerin A, Pannier B et al. Increased systolic pressure in chronic uremia. Role of arterial wave reflections. J Hypertens 1992; 20: 10–9.

26. Mc Eniery C, Hall I, Qasem A et al. Normal vascular aging: differential effects on wave reflection and aortic pulse wave velocity: the Anglo-Cardiff Collaborative Trial (ACCT). J Am Coll Cardiol 2005; 46: 1753–60.

27. Cecelja M, Chowienczyk P. Dissociation of aortic pulse wave velocity with risk factors for cardiovascular disease other than hypertension: a systematic review. J Hypertens 2009; 54: 1328–36.

28. The Reference Values for Arterial Stiffness Collaboration. Determinants of pulse wave velocity in healthy people and in the presence of cardiovascular risk factors: establishing normal and reference values. Eur Heart J 2010; 31: 2338–50.

29. Цупко И.В. Гемодинамические нарушения у лиц без артериальной гипертонии с множественными факторами риска развития сердечно - сосудистых заболеваний. Российский национальный конгресс кардиологов. Материалы конгресса. Кардиоваскулярная терапия и профилактика. 2008; 7 (6): 397–8.

30. Олейников В.Э., Гусаковская Л.И., Сергацкая Н.В. Показатели сосудистой ригидности по данным бифункционального суточного мониторирования АД и ЭКГ у нормотензивных лиц разных возрастных групп. III съезд кардиологов Приволжского федерального округа. Материалы съезда. Кардиология ПФО: возможности и перспективы. 2010; с. 54–5.

31. Ghiadoni L, Penno G, Giannarelli C. Metabolic Syndrome and Vascular Alterations in Normotensive Subjects at Risk of Diabetes Mellitus. J Hypertens 2008; 51 (2): 440–5.

32. Корнева В.А., Отмахов В.В., Дружилов М.А., Кузнецова Т.Ю. Артериальная жесткость – новый маркер сердечно - сосудистых заболеваний. Кардиосоматика. 2012; 3 (1): 34–7.

33. Guerin A, Blacher J, Pannier B et al. Impact of aortic stiffness attenuation on survival of patients in end - stage renal failure. Circulation 2001; 103: 987–92.

34. Van Bortel L, Stephane L, Boutouyrie P et al. Expert consensus document on the measurement of aortic stiffness in daily practice using carotid - femoral pulse wave velocity. J Hypertens 2012; 30 (3): 445–8.


Review

For citations:


Druzhilov M.A., Otmakhov V.V., Beteleva Yu.E., Korneva V.A., Kuznetsova T.Yu. Subclinical vessel lesion in normotensive patients with abdominal obesity: focus on arterial stiffness. Systemic Hypertension. 2013;10(2):46-52.

Views: 100


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 2075-082X (Print)
ISSN 2542-2189 (Online)