Evaluation of arterial stiffness by pulse wave velocity method in resistant and controlled hypertensives / Avaliação da rigidez arterial pelo metodo da velocidade de onda de pulso (VOP) em hipertensos resistentes e controlados

AUTOR(ES)
DATA DE PUBLICAÇÃO

2009

RESUMO

Introduction: In hypertensive patients, there is a relationship between morbidity and mortality and arterial damage, affecting one or several organs like: heart, brain, kidney and others. Therefore, large arterial injuries require early evaluation of cardiovascular risk factors, once they are major contributors to cardiovascular diseases. Among the simple and non-invasive methods of arterial assessment, the Pulse Wave Velocity (PWV) measurement is widely utilized as an index of arterial stiffness and elasticity, for being accurate, simple, reproducible and usually applied in clinical trials. Objectives: To detect PWV alterations in arterial resistant and controlled hypertensive patients when compared to subjects with no hypertensive disease, during two periods. Materials and Methods : This study assessed 129 subjects: 42 Resistant Hypertensive (RH) patients, 46 Controlled Hypertensive (CH) patients and 41 subjects with no hypertensive disease, representing the Control group (CT). The study was performed in two phases – it began at an initial therapeutic optimization time (phase 0) and, after 6 months, patients were reassessed with their usual treatment associated to a spironolactone dose of 25 mg/day (phase 1). Results: In phase 0, PWV value of the CT group (7,8±1,06 m/s) was lower than the CH group (8,6±1,26m/s), which was lower than the RH group (9,3±1,5 m/s). In phase 1, results followed the same pattern: CT group = 7,8±1,12 m/s, CH group = 8,42±1,19 m/s and RH group = 9,4±1,45 m/s. Conclusions: PWV alterations found in groups RH and CH suggest an increase in arterial stiffness in these groups. Results indicate that higher PWV values are associated to moderate-to-severe levels of hypertension. The association of spironolactone did not alter PWV values, apparently, not interfering in vascular remodeling. Regarding PWV, additional studies are necessary with an increased number of patients, for a longer period.

ASSUNTO(S)

espironolactona cardiovascular diseases hipertensão spironolactone doenças cardiovasculares hypertension

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