Large artery hemodynamics in elderly patients with arterial hypertension

Aim. To study velocity and volume parameters of hemodynamics, as well as their relation to larger artery remodelling, in elderly patients with arterial hypertension (AH). Material and methods. In total, 46 elderly AH patients, aged 61-90 years (mean age 75,6±0,7 years), were examined; 62,2% were aged over 80 years. Mean AH duration was 16,0±1,0 years. The examination included duplex scanning of common carotid artery (CCA), brachial artery (BA), and femoral artery (FA). Intima-media thickness (IMT), artery diameter (AD), peak (V_max), minimal (V_min) and mean maximal (Vta_max) blood flow velocity, blood volume per vessel section per 1 second (Q cm3/s), and specific blood kinetic energy (hv cm²/s²) were measured. Endothelium-dependent and endothelium-independent vasodilatation (EDVD, EIVD), as well as pulse rate velocity (PRV), were also assessed. Results. In elderly AH patients, all large arteries demonstrated increased IMT (by 12,5%, compared to healthy controls; p<0,001), while AD for CCA and BA was increased by 29,8% and 15,4%, respectively (р><0,001). For FA, there was a tendency towards reduction in all velocity parameters. For CCA and BA, velocity parameters were ><0,001), while AD for CCA and BA was increased by 29,8% and 15,4%, respectively (р<0,001). For FA, there was a tendency towards reduction in all velocity parameters. For CCA and BA, velocity parameters were independent from minimal and maximal systolic blood pressure, SBP (SBP_max, SBPmin). For FA, BP_max negatively correlated with V_max and Vta_max. For CCA and BA, Q parameter was significantly higher than in controls in all hemodynamic phases, while for FA, it was the same as in controls. Compared to healthy controls, FA blood volume in Vta_max phase was reduced by 40%, with increased blood flow in CCA and BA and a 20% reduction in low extremities blood flow. PWV was similar in elderly AH patients and controls for CCA, while for BA and FA, it was increased in those with AH. There was no association between PWV and BP. Conclusion. In elderly AH patients, CCA and BA remodelling was characterised by increased IMT and AD parameters. Blood flow was increased in CCA and BA and decreased in FA, which resulted in lower extremities blood flow reduction by 20%, compared to healthy controls.

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