Effect of nondipper hypertension on coronary artery disease progression in patients with chronic coronary syndrome

Background/aim: It has been suggested that there is a significant progress in coronary artery disease (CAD) by many pathophysiological mechanisms. Nondipper hypertension (NDH) has been shown to have higher target organ damage and have a higher rate of cardiovascular mortality and morbidity. In this study, we investigated the effect of nondipper hypertension on the progression of coronary atherosclerosis. Materials and methods: A total of 186 patients who underwent coronary angiography twice between 6 months and 3 years were included in the study. Coronary angiography was repeated on the admission day due to angina or positive exercise test and the patients were divided into groups. Results: Progression of coronary artery disease was detected in 58 of 186 patients. Seventy-one of the total patients were found to be nondipper hypertensive. Nondipper hypertension, hypertension, diabetes mellitus, low-density lipoprotein, and total cholesterol were found to be effective in the progression of CAD. Among these parameters, it was seen that nondipper hypertension and hyperlipidemia were the most important independent risk factors. Conclusion: Coronary artery disease is a progressive disease, and this progression depends on many reasons. In our study, we showed that nondipper hypertension is a new parameter that is effective in CAD progression.

An investigation of the relationship between arterial aortic stiffness and coronary slow flow that was detected during coronary angiography.

AIM: Increased intimal thickness in coronary arteries, extensive calcification, and atheromatous plaque that does not cause luminal irregularities in a significant portion of the patients with coronary slow flow (CSF). Arterial stiffness is an indicator for atherosclerosis. We aimed to investigate the relation between coronary slow flow phenomenon (CSFP) and arterial stiffness. METHOD: Total of 73 patients were included in the study, and a control group was formed with 64 individuals. Aortic stiffness index ß (ASIß) and pulse wave velocity (PWV) were used as the determinant of arterial stiffness in all analyses. RESULT: Pulse wave velocity values were significantly higher in the coronary slow flow group than the control group (P < .001). PWV, aortic stiffness index ß (ASIß) values were found to be significantly higher in the CSF group. ASIß value was 3.4 ± 1.0 in CSF patients and 2.2 ± 0.6 in the control group (P < .001). Receiver operating characteristic curve (ROC) analysis showed that PWV predicted coronary slow flow with 97% sensitivity and 90% specificity for 7.15 cutoff value. And aortic stiffness index was found to predict coronary slow flow with 83% sensitivity and 75% specificity for 2.63 cutoff value. CONCLUSION: Our findings prove that coronary slow flow phenomenon should be considered a subgroup of coronary artery diseases and that increased PWV is an indicator of CSFP.