engleski

Arterial stiffness in patients with hypertensive crisis

The aim of this study was to determine if patients with the hypertensive crisis have higher pulse wave velocity compared to the patients with arterial hypertension without it. In this case- control study which lasted from January 2020 to December 2021, 61 patients (36 males, 25 females) with the hypertensive crisis were analyzed at the Emergency department in Clinical Hospital Merkur, Zagreb. The hypertensive crisis was defined as a rapid increase in systolic blood pressure above 180 and/or diastolic above 120mmHg (SBP range 181– 208mmHg). On the other hand, in the control group, we analyzed 45 patients (24 males, 21 females) with confirmed arterial hypertension by a 24h- ambulatory blood pressure monitor (BTL Cardiopoint, SBP > 130/80mmHg or taking antihypertensives) without evidence of hypertensive crisis (SBP range 115–156mmHg) in two family medicine practices. Elementary lab results and pulse wave velocity (by Agedio B900) were checked in all patients. Patients were divided into two additional groups by age (51–60, 42 patients and 61–70 years, 64 patients). Mann- Whitney U test was used for the analysis of non- parametric variables in Statistica v.10.0. Patients with hypertensive crisis had a significantly higher heart rate (median 78 vs. 69 bpm, U = 714 ; p < 0.001), fasting glucose (median 5.5 vs. 6.0 mmol/L, U = 804.5 ; p < 0.01), body mass index (median 31.0 vs. 27.9 kg/m2, U = 889 ; p < 0.001), nocturnal SBP drop (median 15.5 vs. 9.8%, U = 386 ; p < 0.05), and augmentation index (median 42 vs. 19%, U = 686 ; p < 0.001). In both younger and older group, patients with hypertensive crisis had statistically significantly higher pulse wave velocity (median younger: 9.3 vs. 8.1m/s, U = 65.5 ; p < 0.001 ; older: 10.7 vs. 9.0m/s, U = 19 ; p < 0.001) shown in the Figure 1. In younger group patients with hypertensive crisis have 8.5 times higher chances of having pulse wave velocity above reference value (>8.0m/s ; CI = 1.57–46.87, p < 0.001) while in older group that chance was 108 times higher than in controls (reference value >9.5m/s ; CI = 13.83–843.33, p < 0.001). Patients with hypertensive crisis had statistically higher pulse wave velocity values, heart rate, fasting glucose, body mass index, and nocturnal SBP drop compared to patients with arterial hypertension without crisis.

Arterial Stiffness ; Hypertensive Crisis

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