Arterial Stiffness Parameters and Subendocardial Viability Ratio in Patients with Arterial Hypertension Affected by Subclinical and Clinical Atherosclerosis

Aim . Assessment the arteries' stiffness parameters and subendocardial viability ratio in hypertensive patients with various degrees of severity of the atherosclerotic process manifestation. Material and methods . 133 hypertensive patients were divided into 3 groups, similar in age and sex, depending on the severity of the atherosclerotic process: hypertensive patients without atherosclerosis (n=42; 53.3±7.6 years); patients with hypertension and  subclinical  atherosclerosis  (SА) (n=52; 56.5±8.0 years); patients with hypertension and coronary artery disease (CAD) (n=39; 57.4±6.8years) and control group which consisted of individuals without cardiovascular diseases (n=33; 54.6±8.4 years). All participants underwent 24-hour blood pressure monitoring with assessment of arterial stiffness parameters and subendocardial viability ratio (SERV). Results . Subjects from all groups with hypertension have significantly higher mean systolic blood pressure (SBP) (131.1±11.9, 127.8±14.8, 128.6±15.3 respectively; p<0.001), as well as central systolic blood pressure (SBPao) (122.0±11.0, 118.8±12.7, 119.9±13.3 respectively; p<0.001), pulse pressure (PP) (46.4±9.8, 45.6±10.6, 48.9±12.0 respectively; p<0.05) and central pulse pressure (PPao) (35.5±8.5, 34.9±8.5, 38.5±9.6 respectively; p<0.05), pulse wave velocity in aorta (PWVao) (11.3±1.5, 12.3±1.8, 11.5±1.7 respectively; p<0.05) compared with control group (SBP 116.3±7.3; SBPao 108.9±6.4, PP 39.9±6.5, PPao 30.9±5.4, PWVao 10.4±1.3). In hypertensive patients with SA, PWVao was significantly higher compared to other groups (p<0.05). With bringing the indicator to SBP 100 mmHg and HR=60 beats/min, there were no differences between the control group and the group with hypertension (p=0.3), also groups with hypertension+SA and hypertension+CAD did not significantly differ from each other (p=0.6). SERV in subjects with hypertension+SA was significantly lower than in patients with hypertension (p<0.05) and no significant differences were detected with the group with hypertension+CAD (p=0.77). Conclusions . In hypertensive patients with SA, a decrease in subendocardial perfusion is associated with an increase in pulse wave velocity in aorta. Moreover, such a decrease in perfusion approaches to the values of patients suffering from coronary artery disease, which indicates significant changes in the small vessels of the heart that form the coronary reserve.