[Systemic and local stiffness of the arteries in young patients with arterial hypertension].

UNLABELLED: The aim of the work was to study characteristics of systemic and local arterial stiffness in young patients with arterial hypertension (AH) suffering this condition in the childhood or adulthood and to relate them to risk factors of cardiovascular complications. Materials and methods. 54 patients aged 18-35 (mean 25.3 +/- 3.4) years with AH. 37 of them had AH since 18 year and 27 ones starting from the childhood or adulthood Control group included 26 healthy volunteers aged 25.8 +/- 3.7 year. The carotid-femoral pulse wave propagation rate (PWPR) was measured by applanation tonometry with a SphygmoCor apparatus. Parameters of carotid stiffness of CCA were studied by the echo-tracking method using Aloka ProSound a7 device. Results. Patients with AH and without it in the childhood or adulthood showed higher PWPR values than controls (7.1 +/- 1.2 and 7.5 +/- 1.4 vs. 6.3 +/- 1.0 m/s respectively) Ep and AC values were higher in patients who did not have AH in the childhood or adulthood: right Ep 89 +/- 24.4 and 68.7 +/- 18.4 kPa, AC 0.9 +/- 0.2 and 1.1 +/- 0.1 mm2/kPa respectively; left Ep 86.1 +/- 20.3 and 71/4 +/- 16 kP AC 0.9 +/- 0.2 and 1.1 +/- 0.1 mm2/kPA (p < 0.05). In the patients with AH since the childhood or adulthood with concomitant metabolic syndrome (MS) the PWPR values and carotid artery stiffness were higher than in the absence of MS (p < 0.05). CONCLUSION: Young patients with AH showed carotid-femoral PWPR compared with control regardless of AH in the childhood or adulthood Parameters of local carotid stiffness were increased only in patients having no AH in the childhood or adulthood Patients with AH since the childhood or adulthood with concomitant MS had higher carotid stiffness and carotid-femoral PWPR than in the absence of MS

[Vasomotor endothelial dysfunction in young men with grade 1 arterial hypertension].

In order to study vasomotor endothelial function and risk factors of endothelial dysfunction in young men with grade 1 arterial hypertension (G1AH) we examined 76 men with G1AH and 30 healthy men aged 20-40 years. Flow-mediated vasodilatation (FMD) of the brachial artery was assessed by ultrasonic method of Celermajer D.S. Vasomotor endothelial dysfunction (FMD<6%) was found significantly more frequently in men with G1AH than in healthy men (51% vs 13%). In healthy young men with normal blood pressure smoking was the main risk factor of endothelial dysfunction. In young men with G1AH risk factors for endothelial dysfunction were: family history of early cardiovascular disease, smoking, and elevation of low-density cholesterol level. Probability of endothelial dysfunction in the absence of these factors was low - 11%, in the presence of one factor it was 30%, two factors - 60%, and three factors - 83%. Elevated (>14.8%) red blood cell distribution width (RDW) was associated with endothelial dysfunction. Probability of endothelial dysfunction in young men with G1AH and elevated RDW was 5 times greater than in those with normal RDW.

[Changes in pulse wave velocity in the reactive hyperemia as a method of evaluation of endothelial vasomotor function in hypertensive patients].

AIM: To assess the method of pulse wave velocity (PWV) measurement in reactive postocclusion hyperemia test for investigation of vasomotor endothelial function (VEF) in hypertension patients. MATERIAL AND METHODS: A total of 50 hypertensive patients participated in the study: 40 patients (age 20-72 years, 19 females, 21 males) with arterial hypertension of degree I-III with moderate and high risk and 2-30 year duration of the disease and 10 healthy normotensive 20-50 year old males (a control group). VEF was evaluated by two methods: ultrasound test with reactive hyperemia according to D.S. Celermajer (Vivid 7 unit) and measurement of PWV in the test of reactive postocclusive hyperemia on the arteries of the upper limbs (VaSera VS-1000 device). RESULTS: According to the ultrasound method, flow-dependent vasodilatation (FDVD%) in hypertensive patients was 15.0 to 5.8% (mean 3.8 +/- 0.9%) and was lower than in healthy persons (16.0 to 8.0, mean 11.6 +/- 0.8%, p < 0.001). Endothelial dysfunction (FDVD < 6%) was found in 20 (67%) hypertensive patients. In reactive postocclusion hyperemia control group demonstrated PWV lowering and its relative changes (delta PWV%) was 124 to 5.3% (mean 8.8 +/- 0.9%). In hypertensive patients delta PWV% ranged from 11.8 to 5.9% (mean 4.9 +/- 0.8%) that is lower than in healthy subjects (p = 0.001). The linear regression analysis has revealed a positive correlation between FDVD and delta PWV (r = 0.54; p = 0.0003). In delta PWV = 5.1% sensitivity and specificity of the method for detection of VEF disturbance were 65 and 90%, respectively. CONCLUSION: The technique of PWV measurement in the reactive postocclusion hyperemia test with satisfactory sensitivity and specificity can be used in hypertensive patients for detection of VEF defects in the arteries of the upper limbs.