Back to Search Start Over

Arterial stiffness in atherosclerotic renovascular hypertension

Authors :
Dražen Perkov
Bojan Jelaković
Vedran Premužić
Mario Laganović
Ljiljana Fodor
Živka Dika
Vanja Ivković
Tajana Željković Vrkić
Marijana Živko
Source :
Journal of Hypertension. 32:2238-2245
Publication Year :
2014
Publisher :
Ovid Technologies (Wolters Kluwer Health), 2014.

Abstract

Arterial stiffness is an independent cardiovascular risk factor. Aging, high blood pressure and increased renin-angiotensin system activity contribute to increased arterial stiffness in patients with atherosclerotic renovascular hypertension (aRVH). A literature search failed to identify any study related to this topic. Therefore, our aim was to determine the arterial stiffness in patients with aRVH and analyze whether stenting in addition to multifactorial drug therapy has beneficial effects on markers of stiffness and the clinical course. In this 6-month longitudinal study, 37 patients with refractory hypertension and unilateral aRVH were enrolled. After stenting, all patients received multifactorial dug therapy including 80 mg of telmisartan. Arterial stiffness indices were determined using Arteriograph. The control group consisted of 44 patients with essential hypertension. There were no differences in brachial blood pressure values between the two groups (P > 0.05). At baseline, adjusted pulse wave velocity (PWV) was higher in aRVH patients than that of essential hypertensive patients (12.8 ± 0.4 vs. 11.6 ± 0.3 m/s ; P = 0.029). In the aRVH group, at the end of the follow-up, a significant decrease in the aortic augmentation index (37.7 ± 9.9 vs. 33.7 ± 11.4 ; P = 0.02) without changes in PWV was observed (P > 0.05). This study is the first to show that arterial stiffness is higher in patients with refractory aRVH than in those with essential hypertension. Multifactorial therapy based on stenting and intensive medical treatment reduced central blood pressure and augmentation index. Failure to obtain PWV reduction is likely a consequence of the present irreversible structural vessel changes. Longer follow-up might enable us to resolve whether arterial stiffness indices have better predictive ability in patients with aRVH than brachial blood pressure.

Details

ISSN :
02636352
Volume :
32
Database :
OpenAIRE
Journal :
Journal of Hypertension
Accession number :
edsair.doi.dedup.....3f4a4b47c50a7c68f220a58ca1c1b9d4
Full Text :
https://doi.org/10.1097/hjh.0000000000000324