To assess the role of fibromuscular dysplasia (FMD) in arterial hypertension occurrence and progression (AH) in patients with acute coronary syndrome (ACS).Design and Method:
We examined 386 patients with ACS (189 female, age 40.5 ± 8.7 years). All patients underwent coronary and renal angiography, ambulatory blood pressure monitoring (ABPM), ultrasound of the carotid and renal arteries. All patients were divided into 2 groups: the 1st (n = 31) – 8% patients with ACS and intact tortuous coronary arteries (ITCA), the 2nd (n = 355) - patients with ACS and atherosclerotic vascular lesions.Results:
In 8 % of patients with ACS had ITCA. Among 1st group of patients in 93.5% cases registered ITCA in women (n = 29). Among 2nd group of patients predominated men 70.1% (n = 249). Patients of the 1st group had mostly distal type of ITCA (80.6%) and 19.35% patients had a combination of proximal and distal convoluted types of coronary arteries. According ABPM all 1st group patients had AH, only 65.1% 2nd group patients had AH. BP was significantly higher in the 1st group (175 ± 4.5 mmHg vs 142 ± 4.7). During the renal angiography in 87% 1st group patients diagnosed FMD of the renal arteries, while according ultrasound of renal arteries in 74.1% patients (n = 23), among 2nd group of patients there were normal renal arteries. Only 15.2% patients (n = 54) of the 2nd group had hemodynamic not significant atherosclerotic plaques of the renal arteries which occurred stenose of the lumen not more than 20%.Conclusions:
FMD it is not a rare cause of secondary AH and ACS in women with ITCA in the cardiologist practice. Conducting noninvasive ultrasound of renal arteries is necessary in routine clinical practice for early screening of renal and coronary lesions in order to improve primary prevention of cardiovascular events.