Aortic flow propagation velocity as an early predictor of high coronary risk in hypertensive patients.

AIM: To assess the value of aortic flow propagation velocity (Vp) in detecting hypertensive patients with coronary risk. METHODS: The study included 120 patients with hypertension. According to the 10-year risk of coronary heart disease the patients were categorized in the three groups: 10-year risk < 10% (I),10 - year risk=%10 - 20 (II), and 10-year risk > 20% (III). The aortic flow propagation velocity (Vp) was measured from descending aorta with color M-mode echoardiography. The slope of the first aliasing contour was accepted as Vp. It was compared with Framingham coronary risk score, carotid intima media thickness and high sensitive C-reactive protein. Twelve patients were excluded from the study due to poor acoustic window. RESULTS: The Vp was significantly lower (p<0.001), carotid intima media thickness and high sensitive C-reactive protein was significantly higher in group III (p=0.002 and p=0.014). The area under ROC curve of Vp, carotid intima media thickness and high sensitive C-reactive protein were 0.890, 0,700 and 0.664, respectively. There was a significant inverse relation between Vp and carotid intima media thickness (r=-0.37; p<0.001). CONCLUSIONS: The aortic flow propagation velocity is a simple, feasible and reproducible marker of atherosoclerosis with an acceptable sensitivity and specificity. There is a need for longitudinal prospective studies to use it routinely.

Impaired aortic elastic properties in young patients with prehypertension.

OBJECTIVES: Although hypertension has been shown to be one of the most important predictors of reduced arterial elasticity, there is not enough data about aortic elastic properties in patients with prehypertension. Accordingly, the current study was designated to evaluate aortic elastic features in young patients with prehypertension. MATERIAL AND METHODS: The study population consisted of 25 newly diagnosed prehypertensive individuals (18 men, mean age=34+/-6 years) and 25 healthy controls (16 men, mean age=33+/-6 years) eligible for the current study. Aortic strain, distensibility index and stiffness index beta were calculated from aortic diameters measured by echocardiography and blood pressures simultaneously measured by sphygmomanometry. RESULTS: Prehypertensive patients were detected to have significantly lower aortic distensibility and strain indexes than the controls: (5.77+/-1.91 vs. 8.63+/-2.67 cm dynx10, respectively, P<0.001; strain index: 13.81+/-4.50 vs. 17.47+/-4.25%, respectively, P=0.005). Aortic stiffness index beta of the prehypertensive group, however, was significantly higher than that of the control group (3.73+/-1.41 vs. 2.97+/-0.82, P=0.02). CONCLUSION: Whatever the mechanism, young patients with prehypertension have impaired aortic elasticity compared with healthy controls. This finding has suggested that the development of overt hypertension may be prevented or delayed by using the agents that have the ability to reduce arterial stiffness by regressing and/or preventing functional and structural changes on the arterial wall.