The role of central arterial pressure in cardiovascular remodeling in patients with prehypertension

   Aim. To study the features of vascular remodeling in patients with prehypertension, taking into account the level of the peripheral and central blood pressure compared to the patients with hypertension.
   Material and methods. Inclusion criteria: men 40–55 years. The first group – 92 men with prehypertension, the second – 89 men diagnosed with hypertension, the third – 30 volunteers with normal blood pressure numbers. The estimation of anthropometric indices, blood pressure, heart rate, blood lipid research was performed. We measured ankle-brachial index (ABI), the thickness of the brachiocephalic intima-media, vascular stiffness and central blood pressure parameters.
   Results. Central BP in the first group was 129.0 ± 2.5 mm Hg, in the second group – 130.0 ± 3.5 mm Hg (p < 0,05), in the third – 108.0 ± 2.5 mm Hg. Correlation analysis showed the of links with the central BP and smoking (r = 0.8; p < 0.001), IMT (r = 0.7; p < 0.001) and the presence of dyslipidemia (r = 0.4; p < 0.01). For peripheral blood pressure links with smoking were identified (r = 0.5; p < 0.05). Stiffness index (SI) of large arteries in the 1st group was 7.20 ± 1.99 m / s in the second – 8.90 ± 1.85 m / s in the 3rd – 5.5 ± 1.85. The average value of the reflection index the small resistance arteries (RI) – 36.59 ± 15.43 %, 35.469 ± 14.50 % and 30.39 ± 13.43 in the groups, respectively. Augmentation index in the groups were comparable. PWV>10 m / s was found in 3 % and 4 % in the first and second groups, respectively, in the third group, the value of PWV> 10 m / s have not been diagnosed. The differences between the groups did not reach statistical significance. In patients with PH in the test with mental and emotional stress the growth of SBP and heart rate appeared greater compared with the 2nd and 3rd groups (p < 0.05), increase in diastolic blood pressure more than in the third group (p < 0.05) .

   Conclusions. People with prehypertension have a comparable rate of endothelial dysfunction, arteriosclerosis and brachiocephalic atheroma, but a lower incidence of atherosclerosis of the lower extremities compared to the hypertension. Patients with prehypertension in 40 % have high normal BP, a greater incidence of brachiocephalic atherosclerosis and lower extremities vessels compared to normal central BP. Central blood pressure correlated with risk factors for CVD, ABI and brachiocephalic intima-media thickness.

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