PS-C34-8: INFLUENCE OF RISK FACTORS IN THE DEVELOPMENT OF ARTERIAL STIFFNESS IN PATIENTS WITH UNCONTROLLED ARTERIAL HYPERTENSION
Abstract
Introduction: Arterial stiffness is an unfavorable prognostic marker in patients with arterial hypertension (AH). Early diagnosis of the development of arterial stiffness contributes to the selection of pathogenetic therapy aimed at vascular protection. As noted in the recommendations for hypertension, markers of vascular damage in hypertension are pulse pressure (PP) and pulse wave velocity (PWV) > 10 m/s. However, in the conditions of practical medicine in our republic, there is no possibility of applanation tonometry to assess PWV. Aim: to search for risk factors associated with the early development of arterial stiffness in patients with uncontrolled hypertension. Material and Methods: 133 patients with an average age of 59.13 ± 8.18 years with uncontrolled hypertension, 22.5% of who were smokers. All patients underwent office blood pressure measurements, ECG, duplex scanning of the carotid arteries, applanation tonometry to determine PWV (Sphygmocor, Atcor, Australia) on the segment of the carotid-femoral artery, lipid spectrum, creatinine, and blood serum glucose. Results: Office systolic, diastolic and pulse BP (SBP, DBP and PP) were 164.92 ± 19.0 mm Hg, 99.2 ± 9.08 mm Hg, 65.73 ± 13.67 mm Hg, which corresponded to 2 degrees of arterial hypertension. Central SBP, DBP and PP: 166.96 ± 29.75 mm Hg, 84.8 ± 14.59 mm Hg, PD 81.96 mm Hg. respectively. An increase in PP characterized the development of vascular stiffness in patients with uncontrolled hypertension. At the same time, PWV was 10.8 ± 2.03 m/s; in 60% of patients, PWV exceeded the standard values (> 10 m/s). There was a thickening of the thickness of the intima-media complex (IMC) of the common carotid artery up to 1.11 ± 0.18 mm. The correlation analysis performed showed a direct correlation between PWV and the age of patients (r = 0.383, p = 0.0001), tobacco smoking (r = 0.2, p = 0.004), SBP (r = 0.15, p = 0.046), blood glucose level (r = 0.2, p = 0.008), CMM thickness (r = 0.3, p = 0.0001). Conclusion: The results showed an association of age, SBP, smoking, fasting glucose levels, IMT thickness with the development of arterial stiffness in patients with uncontrolled hypertension. These markers can be determined at the primary health care level and included in the stratification of the risk of vascular damage in patients with uncontrolled hypertension.