P117 ARTERIAL STIFFNESS, CAROTID REMODELING AND OTHER RISK FACTORS DETERMINING CORONARY ARTERY DISEASE IN HYPERTENSIVE PATIENTS

Abstract

Increased arterial stiffness and carotid artery Intima-Media Thickness (IMT) are associated with atherosclerosis and Coronary Artery Disease (CAD), but their correlation with the anatomic extent of atherosclerosis in hypertensive patients is not completely known. We aim to evaluate whether Pulse Wave Velocity (PWV), carotid IMT and Vascular Aging Index (VAI) predict CAD in hypertensives. We enrolled 76 consecutive patients (36 males; mean age 58.2 years) with arterial hypertension who were undergoing elective coronary angiography for the diagnosis or exclusion of CAD. Carotid-femoral pulse wave velocity (PWV), vascular aging index (VAI) calculated from the second derivative of photopletismography, and carotid IMT and diameter (CD) measured by high definition echotracking device were done in all subjects. Correlations between hemodynamic data, traditional cardiovascular risk factors and the presence or absence of CAD were analyzed. CAD (stenosis ≧ 50% in at least one coronary) was observed in 52 patients. Results: Concerning clinical, demographic and laboratory parameters there were no significant differences between patients with and without CAD. PWV in patients with CAD were significantly higher (10.7 vs. 11.87 m/s)(p = 0,01), but the correlation disappeared after adjustment for age. Carotid IMT and CD were similar in patients with and without CAD. Logistic regression analysis showed that patients older than 60 years, with PWV > 12 m/s, CD > 7.67 mm, VAI > −0.05, and cholesterol levels > 200 mg/dl had a significantly higher percentage of CAD than its counterparts. In conclusion, the presence of CAD enhances age-induced changes of arterial stiffness in hypertensive patients. Besides classical cardiovascular risk factors, significant changes in PWV and CD could identify CAD in high risk hypertensive patients.