Vascular Remodeling And Arterial Stiffness In Hypertensive Patients With Obesity

Abstract

Objective. To investigate the peculiarities of common carotid artery (CCA) remodeling and stiffness in hypertensive patients with obesity. Design and method. 82 hypertensive patients with preserved LV systolic function had been observed, including 26 non-obese patients (1st group), 30 patients with the 1st degree of obesity (2nd), and 26 with the 2nd-3rd degree of obesity (3rd). An ultrasound examination of CCA gave a possibility to classify the patients according to its geometry (A.V. Agafonov, 2007) and to calculate the CCA stiffness indices. The statistical analysis was conducted using Mann-Whitney and Pearson χ2 methods. Results. Normal CCA geometry in the 1st gr. was observed in 17 (65,4%) patients, 2nd - 17 (56,7%), 3rd - 15 (57,7%), р=0,035; concentric remodeling – in 4 (15,4%), 4 (13,3%) and 2 (7,7%) accordingly; concentric hypertrophy (CH) – in 4 (15,4%), 6 (20,0%) and 7 (26,9%, р=0,035 within group); eccentric hypertrophy (EH) – in 1 (3,8%), 3 (10,0%) and 2 (7,7%) patients. Intima-media (IMT) thickening was observed in 42,3% non-obese and 64,3% obese patients, р=0,032. Petersen (Pet), Young (Einc) elastic modules as well as pulse wave velocity (PWV) were increasing with the degree of obesity, p>0,05. Cluster analysis by meanings of Pet and Einc gave a possibility to distribute the patients to 3 clusters, p=0,086. Body weight in the 1st cluster was 86,6 (73,5; 97,5) kg, 2nd – 91,7 (80,0; 100,9), 3rd – 98,3 (79,0; 108,8), p=0,059; body mass index (BMI) – 31,0 (28,8; 35,2) kg/m2, 31,3 (28,1; 37,3) and 32,1 (28,9; 35,8), p>0,05; waist circumference – 106,5 (99,5;112,5) cm, 112,5 (100,3; 117,5) and 115,5 (103,0; 119,5), p=0,071; W/H ratio – 0,94 (0,91; 1,01), 0,96 (0,91; 0,98) and 0,97 (0,94; 1,04), p=0,048. The age, levels systolic and pulse BP also had the highest values in the patients with higher stiffness indices, p<0,01. Conclusion. Hypertensive patients with obesity were characterized by higher prevalence of CCA remodeling. Arterial stiffnes indices were associated with age, weight, waist circumference, W/H ratio, SPB and PBP, but not BMI of patients.