Vascular wall structure and function in patients with CHD, AH, and their combination

Aim. To assess the changes in vascular wall structure and function among patients with coronary heart disease (CHD), arterial hypertension (AH), or CHD and AH combination.

Material and methods. In total, 3 groups of the patients (n=120) were examined. Group I included 34 CHD patients (mean age 57,3±10,4 years; 76% men; 54% smokers). Group II included 46 patients with CHD and AH (mean age 62,4±6,5 years; 41% men; 15% smokers). Group III included 40 AH patients (mean age 56,8±9,2 years; 68% men; 30% smokers). Common carotid artery (CCA) structure was assessed by intima-media thickness (IMT). Pulse wave velocity (PWV) and augmentation index were assessed, based on the data for brachial artery. Atherosclerotic changes in lower extremity arteries were evaluated using ankle-brachial index. Other assessed parameters included CCA distensibility and stiffness β; ankle-brachial PWV, as a marker of regional artery stiffness; and brachial artery flow-dependent vasodilatation, FDVD in reactive hyperemia test.

Results. Age- and gender-adjusted IMT increase was more pronounced in patients with CHD and AH (57%). This group was characterised by the lowest values of distensibility and the highest values of local CCA stiffness. The age- and gender-adjusted levels of regional artery stiffness were higher in patients with AH (49%) and participants with CHD and AH (43%).

Conclusion. Patients with CHD and AH were characterised by the highest levels of vascular risk factors, vascular wall remodelling, atherosclerosis of lower extremity arteries, and increased vascular wall stiffness. FDVD was most affected in CHD patients with such risk factors as hyperlipidemia, overweight, or smoking. Therefore, vascular risk factors play a key role in endothelial dysfunction development.

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