[PP.11.20] EXTRACRANIAL CAROTID ARTERY LESIONS AND CAROTID DISTENSIBILITY AT DUPLEX IN LOW-RENIN HYPERALDOSTERONISM

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Abstract

Objective:

To evaluate the prevalence of extracranial carotid artery lesions and carotid distensibility in low-renin hyperaldosteronism in comparison with essential hypertension (EH).

Design and method:

We studied 49 patients with AH. All patients were divided in two groups. Group 1- 22 patients with low renin hypertension (8-with aldosterone-producing adenoma, 14 - with adrenal hyperplasia). Group 2: age-matched 27 patients with EH and normal RAAS. Casual blood pressure levels were 154,8 ± 13,6/95,2 ± 10 mmHg and 140 ± 15,7/85,7 ± 9,1mmHg, respectively (p < 0,05).

Design and method:

Plasma aldosterone concentration (PAC) and PAC were performed by «IMMUNOTEC», FRANCE.

Design and method:

Intima-media thickness (IMT), atherosclerotic plaque of the common carotid artery and carotid bifurcation were evaluated by a high resolution duplex ultrasound technique (IU-22 Philips, Netherlands).

Design and method:

Using a computer assisted method, the maximum and minimum internal diameter and average wall thickness of the right common carotid artery and the following indices of arterial stiffness and distensibility (compliance) were derived: (1) distensibility: the change in carotid artery diameter for a change in blood pressure relative to its systolic diameter; (2) cross-sectional compliance: distensibility multiplied by the cross-sectional area of the artery.

Results:

In Group 1 PAC was significantly higher (mediana 270,1 pg/ml) in comparison with Group 2 (mediana 65,4 pg/ml), p < 0,05. PRA in Group 1 was significanty lower (mediana 0,2 ng/ml/h) in comparison with Group 2 (mediana 0,8 ng/ml/h), p < 0,05.

Results:

Carotid plaques were presented in 73% of low-renin hyperaldosteronism patients and 54% in patients with EH (p = 0,02). However, IMT was not significantly higher in patients with low-renin hyperaldosteronism in comparison with EH(53% vs 45%) (p = NS). In cross-sectional compliance there were no significantly differences in both groups whereas the distensibility coefficient decreased significantly in patients with low-renin hyperaldosteronism in comparison with EH - 22 vs 26 (p < 0,05).

Conclusions:

These results demonstrate that hypertensive patients with hyperaldosteronemia and suppressed PRA display increased atherosclerotic carotid arterial lesions and distensibility coefficient compared with EH and normal RAAS.

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