Blood pressure in patients with brachiocephalic atherosclerosis before and after the intervention

Abstract

Aim. To investigate the associations between brachiocephalic atherosclerosis (BCAS) and arterial hypertension (AH); to study the potential for AH control after surgery.
Material and methods. The study included 70 patients (17 women, 53 men; mean age 62,5±7,5 years), who underwent planned surgery due to BCAS and carotid stenosis, CS (n=50) or brachiocephalic artery (BCA) malformation (n=20). AH duration varied from 4 months to 32 years. Levels of systolic blood pressure (SBP) were 115-192 mm Hg (mean SBP 151,5±27,26 mm Hg). Blood flow in aortal arch arteries was assessed by duplex BCA scanning. BP levels were registered within the 24 hours before the surgery, and then 3-5 days and 1-3 months after the intervention.
Results. In patients with CS, risk of BP elevation increased with age (р=0,04). Before the surgery, higher BP levels were registered in Group I patients: mean BP was 103,6±11,3 mm Hg vs. 91,7±6,6 mm Hg (р=0,00007). After the intervention, these differences were no longer observed. In patients with CS, post-intervention BP levels decreased due to reduction in both systolic BP (from 145,1±14,7 to 135,6±12,3 mm Hg; р=0,02) and diastolic BP (from 83,3±10,2 to 78,1±9,7 mm Hg; р=0,02). In patients with BCA malformation, no significant BP reduction was registered.

Conclusion. In BCAS patients, BP elevation was mostly explained by CS and progressed with age, while surgery facilitated BP reduction.