P62 BLOOD PRESSURE LOWERING HALTS CAROTID ARTERY STIFFENING IN HYPERTENSIVE PATIENTS: THE CATOD STUDY

DOI

10.1016/j.artres.2017.10.084How to use a DOI?

Abstract

Background: We anticipate that in vascular outpatients followed over time, measured changes in arterial stiffness will be the multifactorial result of pressure-dependence, ageing- related degeneration, wall stress homeostasis, and medical treatment. Carotid ultrasound enables assessment of carotid pulse wave velocity (cPWV, via Bramwell- Hill), geometry (relative wall thickness, RWT = 2*IMT/diameter), and intrinsic material stiffness (Young’s-modulus, via Moens-Korteweg). We investigated changes in these carotid properties over time, and their interrelationship. To check whether the change in measured cPWV could be merely due to pressure-dependence, we calculated based on the stiffness index β₀ [2] the theoretical pressure-dependent change in cPWV [3].

Methods: Hypertensive outpatients (n = 147) were assessed at baseline and 3.5±1.1 year follow- up, and were stratified according to baseline-to-follow-up change in diastolic blood pressure (ΔDBP) into three groups: decreasedDBP (ΔDBP < −7 mmHg), constantDBP (−7 mmHg ≤ ΔDBP≤7 mmHg) and increasedDBP (ΔDBP > 7 mmHg), with the cut-off being twice the typical DBP measurement error [1].

Results: The theoretical pressure-dependent change in cPWV was 0.4±1.3 m/s lower (p < 0.001, n = 147), corroborating the anticipated multifactorial conditions. Table 1 shows no changes in cPWV, RWT and Young’s-modulus for decreasedDBP. For constantDBP, both cPWV and Young’s-modulus were increased at follow-up.

IncreasedDBP showed increases in cPWV and Young’s-modulus and a decreased RWT. The latter implies a 9.2±10.7 kPa increase in circumferential wall stress (p < 0.001), in contrast to a 5.3±6.9 kPa decrease (p < 0.001) in decreasedDBP (p < 0.05 for between groups).

n = 147	ΔcPWV [m/s]		ΔRWT [−]		ΔYoung’s-modulus [MPa]
	Mean±sd	p	Mean±sd	p	Mean±sd	p
DecreasedDBP (n = 53)	−0.1±1.4	0.72	0.00±0.04	0.38	−0.01±0.32	0.87
ConstantDBP (n = 67)	+0.6*±1.4	<0.001	0.00±0.04	0.18	+0.10*±0.26	<0.001
IncreasedDBP (n = 27)	+0.5*±1.5	0.029	−0.02*,**±0.04	0.002	+0.19*±0.35	<0.001

Δs calculated as follow-up – baseline.

*:

p < 0.05 compared to decreasedDBP.

**:

p < 0.05 compared to constantDBP.

The bold indicates that there is a statistically significant difference between follow-up and baseline.

Table 1.

Changes in measure carotid properties with 3.5-year follow-up.

Conclusions: In this outpatient cohort, with clear DBP reduction, there is a discontinuation of carotid stiffening, but no reversal. In patients with increased DBP, progressive carotid stiffening appears driven by impaired wall stress homeostasis.

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TY  - JOUR
AU  - Siske Bos
AU  - Rosa Maria Bruno
AU  - Bart Spronck
AU  - Maarten Heusinkveld
AU  - Stefano Taddei
AU  - Lorenzo Ghiadoni
AU  - Koen Reesink
PY  - 2017
DA  - 2017/12/06
TI  - P62 BLOOD PRESSURE LOWERING HALTS CAROTID ARTERY STIFFENING IN HYPERTENSIVE PATIENTS: THE CATOD STUDY
JO  - Artery Research
SP  - 71
EP  - 72
VL  - 20
IS  - C
SN  - 1876-4401
UR  - https://doi.org/10.1016/j.artres.2017.10.084
DO  - 10.1016/j.artres.2017.10.084
ID  - Bos2017
ER  -