Key result
Clinically manifested peripheral artery disease in hypertensive patients is associated with significantly higher arterial stiffness, including increased pulse wave velocity, compared to those without peripheral artery disease.
Why the study?
To identify features of arterial stiffness and establish relationships with daily blood pressure profile indicators and peripheral artery disease in hypertensive patients with subclinical or manifested lower extremity atherosclerosis.
Cross-Sectional (n=120)
No
Absolute Event Rate: 11% vs 10.3%
p-value: p=0.03
Clinically manifested peripheral artery disease in hypertensive patients is associated with a pronounced increase in arterial stiffness, indicating a higher cardiovascular risk profile.
Suggests arterial stiffness assessment may identify higher-risk hypertensive patients with PAD; leaves open whether targeting stiffness improves outcomes.
Objective . To identify features of arterial stiffness, to establish relationships with indicators of the daily blood pressure profile and peripheral artery disease in patients with hypertension (HTN) in combination with subclinical and manifested atherosclerotic lesions of the arteries of the lower extremities. Design and methods . 120 patients were divided into 3 groups: group 1-46 patients with HTN and clinically manifested AALE, group 2-39 patients with HTN and asymptomatic AALE, group 3-35 HTN patients without AALE. All patients underwent general clinical laboratory and instrumental research methods, including 24-hour blood pressure ambulatory monitoring (24h-ABPM) with the assessment of 24-hour blood pressure profile and arterial stiffness parameters, ultrasonic triplex scanning (USTS) of the arteries of the lower extremities. Statistical data processing was carried out using Microsoft Office Excel 16 (2015, Microsoft, USA), Statistica 10.0 (StatSoft, USA), IBM SPSS Statistica 26.0 (IBM, USA). Results . Higher values of pulse wave velocity (PWVao), augmentation index (AIx) and ambulatory arterial stiffness index (AASI) were found in the 1 st group in comparison to the 2 nd and 3 rd groups (p < 0,05). Lower reflected wave transit time (RWTT) (119,5 [112;127] ms) was found in the 1 st group (128 [122;132], p = 0,001 and 126 [121;129] ms, p = 0,03 in the 2 nd and and 3 rd groups, respectively) groups. The maximum rate of blood pressure increase (dP/dt max ) in patients of the 1 st (550 [466;666] mm Hg/s) and 2 nd (634 [511;695] mm Hg/s) groups was significantly lower than in patients of the 3 rd group (655 [526;806] mm Hg/s, p < 0,05). A direct correlation was found between AASI values and SBP (r = 0,291, p = 0,049) and its variability (r = 0,301, p = 0,042), AASI and PBP (r = 0,518, p < 0,001), its variability (r = 0,596, r < 0,001) in group 1, as well as AASI and PBP (r = 0,514, p < 0,001) and PBP variability (r = 0,632, p < 0,001) in group 2. A correlation between AIx and the degree of stenosis (%) of the arteries of the lower extremities was found in patients with AH and AALE of varying severity (r = 0,310, p = 0,004). Conclusions . In patients with subclinical course of AALE, lower values of dP/dt max in comparison with HTN patients without AALE indicate an increase in arterial stiffness at the initial stages of peripheral atherosclerosis. Clinically manifested atherosclerotic lesions of the arteries of the lower extremities in HTN patients are associated with a more pronounced increase in arterial stiffness, which contributes to a higher cardiovascular risk.
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Семенцова et al. (2022) conducted a cross-sectional in Hypertension and peripheral artery disease (n=120). Clinically manifested peripheral artery disease vs. Hypertension without peripheral artery disease was evaluated on Pulse wave velocity (PWVao) in m/s (p=0.03). Clinically manifested peripheral artery disease in hypertensive patients is associated with significantly higher arterial stiffness, including increased pulse wave velocity, compared to those without peripheral artery disease.
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