Influence of age and body mass index on arterial stiffness and left ventricular hypertrophy in patients with arterial hypertension II stage.
DOI:
https://doi.org/10.26641/2307-0404.2019.3.181875Keywords:
arterial pressure, arterial hypertension, arterial stiffness, vascular aging, pulse wave velocity, central aortic pressure, amplification pressure, body mass indexAbstract
Based on the cumulative data of scientific research reference values for the central blood pressure and its amplification were proposed in patients with different cardiovascular risk factors. Still, the possibility of its practical implementation in patients of different age groups has not been fully studied. There were examined 132 untreated patients (23 females and 109 males) with uncomplicated essential hypertension, which were divided into 3 groups depending on age (WHO, 2012): I group included 47 patients of the young age, II group - 50 middle-aged patients and III group – 35 elderly patients. Measurements of central systolic blood pressure (cSBP), SBP amplification (SBP Amp), pulse wave velocity (PWV) were carried out by Arteriograph Tensioclinic (Tensiomed, Hungary). Target-organ damage included LVH which was determined by echocardiographic left ventricular mass index (LVMI), adjusted for body surface (g/m2) or height (LVMI2,7), aortic PWV>10 m/s. It was established that the use of a personalized approach in the examination of patients with arterial hypertension makes it possible to increase the efficiency of diagnosis of hypertensive-mediated subclinical organ damage. So in order to identify impairment of the vascular wall in patients of a young age with hypertension, with overweight and obesity, the reference values of PWV and cSBP in accordance with the age norm should be taken into account. It was particularly in this cohort of patients that the greatest adverse effect of vascular stiffness and body mass index (BMI) on the formation of left ventricular hypertrophy was revealed, while in elderly people it is necessary to use the reference values of cSBP, depending on the degree of hypertension.
References
Dzyak GV, Kolesnik TV, Kolesnik EL. [Central aortic pressure on the background of long-term combination antihypertensive therapy]. Ukrainian Medical Chronicle. 2012;90(4):89-93. Russian. Available from: https://www.umj.com.ua/article/39559/centralnoe-aortalnoe-davlenie-na-fone-dlitelnoj-kombinirovannoj-antigipertenzivnoj-terapii
Druzhilov MA, Druzhilova OYu, Otmakhov VV, Kuznetsova TYu. [The pulse wave velosity in the aorta as an additional prognostic criterion for abdominal obesity]. Cardiovascular Therapy and Prevention. 2015;3:5. Russian. doi: https://doi.org/10.15829/1728-8800-2015-3-49-53
Kniazkova II, Zhadan AV, Nesen AO. [Arterial stiffness as a risk factor and therapeutic target for arterial hypertension]. Praktycal anhiology. 2017;76(1):5-14. Ukrainian. Available from: https://angiology.com.ua/ua-issue-article-666
Mitchenko OI, Mamedov MN, Kolesnyk TV, Dieiev AD, Romanov VYu, Kulyk OYu, Shkroba AO. [Prevalence of arterial hypertension in the urban population of Ukraine depending on the degree and type of obesity]. International Endocrinological Journal. 2015;67(3):13-19. Ukrainian. doi: https://doi.org/10.22141/2224-0721.3.67.2015.75265
Rebrova OYu. [Statistical analysis of medical data. Application package STATISTICA]. Moskva: МеdiaSphere; 2002. Russian.
Mitchenko EI, Mamedov MN, Kolesnik TV, Deev AD. [The current profile of risk factors for cardiovascular diseases in the urban population of Ukraine]. Ukrainian Kardiological Jourrnal. Collection of materials XІV Natsional Ukrainian cardiology congress. 2013;76-83. Russian. Available from: http://journal.ukrcardio.org/wp-content/uploads/2013/04D/5_4d_2013.pdf
Nedogoda SV, Ledyaeva AA, Tsoma VV, Chumachok EV, Barykina IN. [Central pressure in the aorta as a target for antihypertensive therapy]. Farmateka. 2011;20:30-37. Russian. Available from: https://lib.medvestnik.ru/apps/lib/assets/uploads/pharmateca/PDF/8313.pdf
World Health Organization. A global brief on hypertension : silent killer, global public health crisis: world health day. 2013;39. Available from: https://www.who.int/cardiovascular_diseases/publications/global_brief_hypertension/en/
Cecelja M, Chowienczyk P. Role of arterial stiffness in cardiovascular disease. RSM Cardiovascular Disease. 2012;1(4):1-10. doi: https://doi.org/10.1258/cvd.2012.012016
McEniery CM, Cockroft JR, Roman MJ, Franclin SS, Wilkinson IB. Central blood pressure: current evidence and clinical importance.European Heart Journal. 2014;35:1719-25. doi: https://doi.org/10.1093/eurheartj/eht565
O’Rourke MF, Staessen Jan A, Vlachopoulos Ch, Duprez Dl, Plantedoc GE. Clinical applications of arterial stiffness; definitions and reference values. American Journal of Hypertension. 2002;15(5):426-44. doi: https://doi.org/10.1016/S0895-7061(01)02319-6
Boutouyrie P, Mattace-Raso F, Hofman A, Verwoert GC, Wittemana JC, Wilkinson I, et al. Determinants of pulse wave velicity in health people and in the presence of cardiovascular risk factors: 'establishing normal and reference values'. The reference values for Arterial Stiffness' Collaboration. European Heart Journal. 2010;31:2338-50. doi: https://doi.org/10.1093/eurheartj/ehq165
Williams B, Mancia G, Spiering W, Agabiti Rosei E, Azizi M, Burnier M, Clement DL, Coca A, de Simone G, Dominiczak A, Kahan T, Mahfoud F, Redon J, Ruilope L, Zanchetti A, Kerins M, Kjeldsen SE, Kreutz R, Laurent S, Lip GYH, McManus R, Narkiewicz K, et al. ESC/ESH guidelines for the management of arterial hypertension. European Heart Journal. 2018;39(33):3021-104. doi: https://doi.org/10.1093/eurheartj/ehy339
Gismondi RA, Oigman W, Neves MF. Antihypertensive agents and arterial stiffness. Journal of Thoracic Disease. 2016;8(7):1386-87. doi: https://doi.org/10.21037/jtd.2016.05.60
Hanboly NH. Arterial stiffness in health and disease. Nigerian Journal of Cardiology. 2017;14(2):65-70. doi: https://doi.org/10.4103/njc.njc_3_17
Herbert A, Cruickshank JK, Laurent S, Boutouyrie P. Reference Values for Arterial Measurements Collaboration. Establishing reference values for central blood pressure and its amplification in a general healthy population and according to cardiovascular risk factors. Eur Heart J. 2014;35:3122-33. doi: https://doi.org/10.1093/eurheartj/ehu293
Janner JH, Godtfredsen NS, Ladelund S, Vestbo J, Prescott E. High aortic augmentation index predicts mortality and cardiovascular events in men from a general population, but not in women. European Journal of Preventive Cardiology. 2013;20(6):1005-12 doi: https://doi.org/10.1177/2047487312449588.
Benetos A, Gautier S, Labat C, Salvi P, Valbusa F, Marino F, et al. Mortality and cardiovascular events are best predicted by low central/peripheral pulse pressure amplification but not by high blood pressure levels in elderly nursing home subjects: the partage (predictive values of blood pressure and arterial stiffness in institutionalized very aged population) study. Journal of the American College of Cardiology. 2012;60(16):1503-11. doi: https://doi.org/10.1016/j.jacc.2012.04.055
Movahed M, Lee J, Lim W, Hashemzadeh M, Hashemzadeh M. Strong independent association between obesity and essential hypertension. Clinical Obesity. 2016;6(3):189-92. doi: https://doi.org/10.1111/cob.12139
O’Rourke MF, Staessen Jan A, Vlachopoulos Ch, Duprez Dl, Plantedoc GE. Consequences of arterial stiffening and increase in central blood pressure in hypertension. Mediographia. 2015;37(4):380-90. ISSN 0243-3397 Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4155427/
Wang JG, Stassen JA, Franclin SS, Fagard R, Gueyffie F. Systolic and diastolic blood pressure lowering as determinants of cardiovascular outcome. Hypertension. 2005;45(5):907-13. doi: https://doi.org/10.1161/01.HYP.0000165020.14745.79
Userʼs manual TensioClinic TensioMed Arteriografand TensioMed Program [Internet]. [cited 2017.10.19] Available from: http://www.tensiomed.com/download/manual_arg_bt_en.pdf
Vlachopoulos C, Aznaouridis K, Stefanadis C. Prediction of cardiovascular events and all-cause mortality with arterial stiffness: a systematic review and meta-analysis. Journal of the American College of Cardiology. 2010;55(13):1318-27. doi: https://doi.org/10.1016/j.jacc.2009.10.061
Downloads
How to Cite
Issue
Section
License
Copyright (c) 2019 Medicni perspektivi (Medical perspectives)
This work is licensed under a Creative Commons Attribution 4.0 International License.
Submitting manuscript to the journal "Medicni perspektivi" the author(s) agree with transferring copyright from the author(s) to publisher (including photos, figures, tables, etc.) editor, reproducing materials of the manuscript in the journal, Internet, translation into other languages, export and import of the issue with the author’s article, spreading without limitation of their period of validity both on the territory of Ukraine and other countries. This and other mutual duties of the author and all co-authors separately and editorial board are secured by written agreement by special form to use the article, the sample of which is presented on the site.
Author signs a written agreement and sends it to Editorial Board simultaneously with submission of the manuscript.
