P.021 Dynamics of Carotid-Radial Pulse Wave Velocity in Occlusion Test is Related to the Target-Organs Damage in Essential Arterial Hypertension

Abstract

Purpose

To evaluate the importance of carotid-radial PWV (PWV-cr) dynamics in cuff occlusion test in heart, vessels and kidneys damage assessment in patients with essential arterial hypertension (AH).

Methods

204 patients with AH (mean age 72.6 ± 7.2 years) were examined. PWV-cr (“PulseTracePWV”, Great Britain) was measured before and after a 5-min forearm cuff occlusion. According to the results of the occlusion test the patients formed two subgroups, in one of which PWV-cr decreased (n = 122), while in the second group (n = 82) it did not change or increased. The cases of previous myocardial infarction (MI) were taken into account. Ankle-brachial index (ABI) and glomerular filtration rate (GFR) by MDRD formula were revealed. For criteria of peripheral artery disease (PAD) we used the ABI value<1.0, while for chronic kidney disease (CKD) it was GFR/1.73 m²<60 ml/min. The incidence of previous MI, PAD and CKD were compared in both subgroups. To estimate relationships we used logistic regression analysis.

Results

The two subgroups of patients were similar in age, gender and PAD incidence. Previous MI and CKD occurred more often in the second subgroup compared with the first (28.9% vs. 13.9%, χ² = 6.9, p = 0.009 and 65.4% vs. 43.7%, χ² = 9.1, p = 0.003, respectively). Logistic regression analysis also proved that the lack of PWV-cr fall in occlusion test is associated with more frequent MI (OR=2.6, p = 0.008) and CKD (OR = 2.4, p = 0.002) development.

Conclusion

PWV-cr dynamics in occlusion test reflecting peripheral arteries reactivity is associated with coronary heart and chronic kidney diseases occurrence and thus can have prognostic significance for target-organs affection.