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Arterial stiffness in atherosclerotic renovascular hypertension
- 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.
- Subjects :
- Male
musculoskeletal diseases
medicine.medical_specialty
animal structures
Physiology
Blood Pressure
Pulse Wave Analysis
Benzoates
Renovascular hypertension
Renin-Angiotensin System
Vascular Stiffness
Risk Factors
Internal medicine
Internal Medicine
Humans
Medicine
In patient
Longitudinal Studies
Telmisartan
Risk factor
Aorta
Aged
business.industry
Blood Pressure Determination
Middle Aged
Atherosclerosis
equipment and supplies
medicine.disease
arterial stiffness
atherosclerotic renovascular hypertension
renal artery stenosis
revascularization
Hypertension, Renovascular
Blood pressure
Hypertension
Cardiology
Arterial stiffness
Benzimidazoles
Female
Stents
Essential Hypertension
Cardiology and Cardiovascular Medicine
business
Angiotensin II Type 1 Receptor Blockers
Subjects
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