PS 02-21 MARKERS OF ATHEROSCLEROSIS AND ARTERIAL STIFFNESS IN PATIENTS WITH ARTERIAL HYPERTENSION AND TYPE 2 DIABETES MELLITUS

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Abstract

Objective:

We aimed to study the degree of atherosclerosis and arterial stiffness in patients with arterial hypertension (HTN) and type 2 diabetes mellitus (DM).

Design and Method:

The cross-sectional study included 55 patients with HTN and DM (19 (38%) males, mean age 61.6 ± 12.7 years, mean office BP 142.5 ± 25.5/82.7 ± 10.7 mmHg, HR 75.4 ± 10.2 beats/min), GFR 64 ± 18.4 ml/min/1.73m2, LDL-C 3.4+1.19 mmol/l). Target HbA1c levels - in 6 (10.9%) patients. All participants received ACEIs, 12 (21.8%) - with beta-blockers, 51 (92.7%) - calcium antagonists, 35 (63.6%) - thiazide diuretics, and 4 (7.27%) received statins. Target BP <140/85 mmHg was reached in 29 (52.7%). Carotid-femoral (CF) and carotid-radial (CR) pulse wave velocity (PWV, Sphygmocor), cardio-ankle vascular index (CAVI) and ankle-brachial index (ABI) (VaSera 1500) were measured. Increased arterial stiffness was defined as pulse pressure (PP) > 60 mmHg, PWV >10 m/s, CAVI > 9.0, atherosclerosis - as ABI < 0.9. ABI > 1.3 indicated noncompressible arteries. Aortic-to-peripheral arteries stiffness gradient was assessed by CF-PVW/CR-PWV ratio with values >1 indicating its the loss.

Results:

Mean PP values - 61.0 ± 14.3 mmHg; 10 (18.1%) patients had PP > 60 mmHg. Mean CR-PWV - 7.7 ± 1.18 m/s, mean CF-PWV – 10.3 ± 2.0 m/s, and CF-PWV >10 m/s in 15 (27.2%) patients. Mean stiffness gradient - 1.3+0.37, CF-PWV/CR-PWV >1 were found in 51 (92.7%) patients. Mean CAVI - 8.5 ± 1.8, CAVI > 9.0 – in 23 (49%) patients. Mean ABI - 1.03 ± 0.1, ABI < 0.9 in 5 (9%), ABI >1.3 in 2 (3.6%) patients.

Conclusions:

Markers of arterial stiffness in HTN patients with DM are more prevalent than markers of atherosclerosis. Detecting of increased arterial stiffness depends on the diagnostic method used. The highest rates of increased arterial stiffness by CAVI measurement and the lowest by PP may reflect their different sensitivity to antihypertensive therapy. Typically, patients with HTN and DM have an early loss of arterial stiffness gradient from aorta to peripheral arteries.

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