Estimation of central aortic pressure in patients with arterial hypertension and atherosclerosis of the arteries of the lower extremities


DOI: https://dx.doi.org/10.18565/therapy.2022.8.41-47

Sementsova N.A., Chesnikova A.I., Safronenko V.A., Skarzhinskaya N.S.

1) Rostov State Medical University of the Ministry of Healthcare of Russia, Rostov-on-Don; 2) Rostov Regional Clinical Hospital, Rostov-on-Don
Abstract. Currently, indicators of central aortic pressure (CAP) in patients with a combination of arterial hypertension (AH) and atherosclerosis of the arteries of the lower extremities (AALE) of varying severity remain insufficiently studied.
Objective: estimation of the main parameters of CAP in patients with AH and AALE.
Material and methods. 120 patients with AH were divided into 3 groups: group 1 – 46 patients with clinically manifested AALE; group 2 – 39 patients with asymptomatic AALE; group 3 – 35 patients with AH without AALE. All patients underwent general clinical laboratory and instrumental research methods, including 24-hour blood pressure monitoring (24h-BPM) with the determination of CAP indicators, USTS of the arteries of the lower extremities.
Results. Higher average daily values of central systolic blood pressure (cSBP) were found in patients of the 2nd group compared to the 3rd (p=0,04). Patients of the 1st group showed lower average daily and daily values of central diastolic blood pressure (cDBP) compared with the 2nd group (p<0,05), as well as higher values of the average daily and daily cDBP in patients of the 2nd group in compared with the 3rd group (p=0,02). Higher values of central pulse BP (cPBP) were established in patients of the 1st group compared with the 2nd and 3rd groups (p <0,05). The indicators of the central augmentation index (AIXao) in patients of the 1st group (38 [29; 45] %) were significantly higher than in patients of the 2nd (30 [23; 38] %) and 3rd (30 [21; 32] %) groups (p <0,05). Higher AIXao values were found in patients with critical lower limb ischemia (39 [29; 46] %) compared to patients with asymptomatic AALE (30 [23; 38] %, p=0,014). The dependence of AIXao on the degree of stenosis (%) of the arteries of the lower extremities in patients with AH and AALE of varying severity was found (r=0,319, p=0,003).
Conclusion. Statistically significantly higher values of cPBD, AIXao and lower values of cDBP in patients with AH and manifested AALE indicate a more pronounced violation of the elastic properties of the main arteries. The data obtained make it possible to judge a greater LV afterload and a decrease in coronary perfusion against the background of a decrease in LV diastolic filling in patients of this group. The dependence of aortic stiffness on the degree of stenosis of the arteries of the lower extremities was revealed.
Keywords: atherosclerosis of lower limb arteries, central aortic pressure, augmentation index, arterial hypertension
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About the Autors

Nadezhda A. Sementsova, postgraduate student of the Department of internal diseases No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia, cardiologist at the Department of cardiac surgery No. 2, Rostov Regional Clinical Hospital. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane. E-mail: n.gorina@inbox.ru. ORCID: https://orcid.org/0000-0002-1666-0340
Anna I. Chesnikova, Dr. med. habil., professor, professor of the Department of internal diseases No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane. E-mail: rostov-ossn@yandex.ru. ORCID: https://orcid.org/0000-0002-9323-592X
Victoria A. Safronenko, PhD in Medicine, associate professor of the Department of internal diseases No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane. E-mail: v.chugunova@mail.ru. ORCID: https://orcid.org/0000-0002-6965-5019
Natalya S. Skarzhinskaya, PhD in Medicine, associate professor of the Department of internal diseases No. 1, Rostov State Medical University of the Ministry of Healthcare of Russia. Address: 344022, Rostov-on-Don, 29 Nakhichevansky Lane. E-mail: tasha84@list.ru. ORCID: https://orcid.org/0000-0002-5034-8625


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