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Pulse Wave Velocity in Hypertensive Patients & the Effectiveness of Nitroglycerin

Author: ZhangZuo
Tutor: LiuDePing
School: Peking Union Medical College , China
Course: Internal Medicine
Keywords: Hypertension Nitroglycerin Arterial stiffness Pulse wave Artery elasticity index Cardiovascular Arteriosclerosis Diabetic Blood pressure levels Average age
CLC: R544.1
Type: Master's thesis
Year: 2007
Downloads: 48
Quote: 0
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Abstract


Background Pulse Wave Velocity(PWV) as a method of arterial stiffness detection has been widely used clinically. Hypertension,atherosclerosis can increase the arterial stiffness and accelerate PWV.2007ESH/ESC guidelines for the management of arterial hypertension suggested that PWV could be used as an important index for the evaluation of hypertension.Microalbuminuria as an independent predictor of cardiovascular disease and index of endothelium dysfunction was getting more and more attention.Objective To investigate PWV in hypertensive patients and to evaluate its relationship with microalbuminuria.To explore the effects of Nitroglycerin(NTG) on PWV.Method 319 subjects,mean age 50.0±10.9(19-81)years,were divided into hypertension(HTN) group and non-hypertension(NHTN) group according to whether he or she had hypertension or not.Left and right sides of Brachial-ankle PWV(BaPWV) were examined.Blood chemistry and microalbuminuria were measured.Simple correlation analysis was used to evaluate the relationship between PWV and age,serum lipid,blood sugar, serum creatine,blood uric acid,microalbuminuria and levels of blood pressure.Both PWV and microalbuminuria were compared between two groups.Multiple stepwise regression method was used to analyze PWV and all possible related factors.36 volunteers,mean age 48.1±10.2(33-73)years,were divided into HTN group and NHTN group according to whether he or she had hypertension or not.Baseline PWV and PWV at 5minutes and 10minutes after sublingual NTG were detected. PWVs were compared between the two groups at different conditions.Results Age,blood sugar and microalbuminuria were correlated with PWV significantly(P＜0.0001,＜0.0001 and＜0.05 respectively).Between 30 to 50 years of age,PWVs of male were higher than those of female at the same age group (P＜0.05～0.01).PWV in HTN group was significant accelerated than that in NHTN group(P＜0.0001), microalbuminuria in HTN group was significant higher than that in NHTN group(P＜0.01).Multiple stepwise regression analysis suggested that age,hypertension and microalbuminuria were correlated with PWV independently,there was no relationship between PWV and blood sugar,serum lipid,serum creatine and serum urea nitrogen.Basal PWV in HTN group was higher than that in NHTN group.PWV was reduced significantly after NTG were given sublingually 5minutes or 10minutes compared with baseline condition(both P＜0.0001) PWV 10 minutes after sublingual NTG rised a little compared with that after 5minutes.PWVs 5 minutes or 10minutes after sublingual NTG in HTN group were higher than those in NHTN group(both P＜0.05).Conclusions1 PWV is accelerated with the increase of age,between 30 to 50 years of age,man s PWV is higher than woman s at the same age group.2 With the increase of microalbuminuria,PWV rise accordingly. PWV can be used to detect endothelial dysfunction.3 Age,microalbuminuria and hypertension are independent influencing factors of PWV.4 Compared with NHTN group,microalbuminuria is higher and is accelerated in HTN group.5 NTG can reduce PWV both in HTN group and NHTN group.NTG may improve arterial stiffness.6 After NTG are given sublingually,PWV in HTN group still higher than that in NHTN group.

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CLC: > Medicine, health > Internal Medicine > Heart, blood vessels ( circulatory ) disease > Abnormal blood pressure > Hypertension
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