Age dynamics of blood pressure in various vascular basins among healthy people and patients with arterial hypertension
Abstract
Aim. To study blood pressure (BP) levels in various vascular basins, as well as to investigate the role of aorta and large artery elasticity (stiffness) in arterial hypertension (AH) development.
Material and methods. In total, 447 normotensive people and 855 AH patients aged 17-90 years were examined. BP in upper and lower extremity basins and arterial stiffness for elastic and muscular type vessels were measured by volume sphygmography method (VaSera-1000, «Fukuda Denshi», Japan). In 218 participants, pulse wave (PW) contour analysis and central BP measurement were performed by applanation tonometry method (SphygmoCor, «AtCor Medical», Australia).
Results. Age BP dynamics for upper and lower extremity basins was similar in normotensives and AH patients. In calf arteries, comparing to brachial artery (BA), BP was more dependent on aorta and large artery stiffness, reflecting damping function of the latter. In BA, BP was more dependent on reflected waves (pressure augmentation) and PW amplification. Measuring lower extremity BP gives a chance to diagnose aorta stiffness-related AH earlier than traditional В A measurement of В P. The latter diagnoses AH only when elastic vessel stiffness increases enough.
Conclusion. Measuring BP in upper and lower extremity basins improves AH diagnostics and arteriosclerosis stage assessment.
About the Authors
I. V. Milyagina
Smolensk State Medical Academy. Smolensk
Russian Federation
Russian Federation
V. A. Milyagin
Smolensk State Medical Academy. Smolensk
Russian Federation
Russian Federation
Yu. M. Pozdnyakov
Moscow Regional Cardiology Center. Zhukovsky
Russian Federation
Russian Federation
I. V. Makarova
Smolensk State Medical Academy. Smolensk
Russian Federation
Russian Federation
K. V. Shpynev
Smolensk State Medical Academy. Smolensk
Russian Federation
Russian Federation
References
1. Оганов Р.Г., Масленникова Г.Я. Смертность от сердечно-сосудистых и других хронических неинфекционных заболеваний среди трудоспособного населения России. Кардиоваск тер профил 2002; 3: 4-8.
2. Kearney P.M., Whelton M., Reynolds К. et al. Global burden of hypertension: analysis of worldwide data. Lancet 2005; 365 (9455): 217-23.
3. Уринский А.М., Кузнецов Р.А., Поздняков Ю.М., Бойцов C.A. Структура факторов риска и относительная частота распространения патологических изменений у больных артериальной гипертензией различных возрастных групп. Кардиоваск тер профил 2006; 4: 33-40.
4. Шальнова С.А., Деев А.Д., Вихирева О.В. и др. Распространенность артериальной гипертонии в России. Информированность, лечение, контроль // Профилактическая медицина. 2001. Т. 4. С. 3.
5. The CAFE Investigators, for the Anglo-Scandinavial Cardiac Outcomes Trial (ASCOT) Investigators. Differential Impact of Blood Pressure-Lowering Drugs on Central Aortic Pressure and Clinical Outcomes. Principal Results of the Conduit Artery Function Evaluation (CAFE) Study. Circulation 2006; 113: 1213-25.
6. Laurent S., Cockcroft J., Bortel L.V., et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications. European Heart J. Special article 2006; 1-18.
7. Раиса A.L., O'Rourke M.F., Kon N.D. Prospective evaluation of a method for estimating ascending aortic pressure from the radial artery pressure waveform. Hypertension 2001; 38: 932-7.
8. Yambe T., Yoshizawa M., Saijo Y. et al. Brachio-ankle pulse wave velocity and cardio-ankle vascular index (CAVI). Biomedicine & Pharmacotherapy 2004; 58: 95-8.
9. Mackenzie I.S., Wilkinson I.B., Cockcroft J.R. Assessment of arterial stiffness in clinical practice. QJM 2002; 95: 67-74.
10. Nichols W.W., Edwards D.G. Arterial elastance and wave reflection augmentation of systolic blood pressure: deleterious effects and implications for therapy. J Cardiovasc Pharmacol Ther 2001; 6: 5-21.
11. Mahmud A., Feely J. Spurious systolic hypertension of youth: fit young men with elastic arteries. Am J Hypertens 2003; 16: 229-32.
12. Laurent S., Katsahian S., Fassot C. et al. Aortic stiffness is an independent predictor of fatal Stroke in essential hypertension. Stroke 2003; 34: 1203-6.
Review
For citations:
Milyagina I.V., Milyagin V.A., Pozdnyakov Yu.M., Makarova I.V., Shpynev K.V. Age dynamics of blood pressure in various vascular basins among healthy people and patients with arterial hypertension. Cardiovascular Therapy and Prevention. 2008;7(2):44-50. (In Russ.)
Views:
900
Email this article 
