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A Journal on Angiology
Official Journal of the , the International Union of Phlebology and the
Indexed/Abstracted in: BIOSIS Previews, Current Contents/Clinical Medicine, EMBASE, PubMed/MEDLINE, Science Citation Index Expanded (SciSearch), Scopus
Impact Factor 0,899
International Angiology 2016 Feb 12
Baroreflex sensitivity and carotid intima-media thickness in risk stratification of prehypertensives and hypertensives
Denisa ČELOVSKÁ 1, Jozef GONSORČÍK 2, Ludovít GAŠPAR 1, Viera ŠTVRTINOVÁ 1 ✉
1 2nd Department of Internal Medicine, Faculty of Medicine, Comenius University, Bratislava, Slovak Republic; 2 Department of Cardiology, East Slovak Institute of Cardiovascular Disease, Pavol Jozef Šafárik University of Košice, Slovak Republic
BACKGROUNDː The aim of the study was to evaluate the clinical significance of baroreflex sensitivity (BRS) and carotid intima media thickness (IMT) in risk stratification of hypertensives and subjects with high normal blood pressure (SHNBP).
METHODSː A total of 20 patients (61±13 years of age, 10 female/10 male) with essential, treated hypertension and 20 subjects (59±8 years of age, 10 female/10 male) with high normal blood pressure were enrolled. The interrelationship between baroreflex sensitivity expressed in ms/mmHg (BRS) and intima media thickness (IMT) of common carotid artery (CCA) in hypertensives and subjects with high normal blood pressure (SHNBP, prehypertensives) was evaluated. BRS was determined by the sequence and spectral method: a five-minute non-invasive beat-to-beat recording of blood pressure (BP) and R-R interval with use of Collin CBM-7000 monitor, controlled breathing at a frequency of 0.1 Hz. Duplex ultrasonographic examination of the carotid wall and IMT of both CCA and carotid bulb were performed in all patients.
RESULTSː Essential hypertension was associated with decreased BRS (r = –0.53, p<0.001). We found out that there was no significant difference between BRS and IMT CCA values in mild treated hypertensives and those in SHNBP. This finding was independent of age- dependent decrease of BRS. SHNBP and hypertensives with critical value BRS ≤ 5 ms/mmHg have significantly increased IMT CCA.
CONCLUSIONː Decreased baroreflex sensitivity is an early sign of autonomic dysfunction even in prehypertensive period. SHNBP and hypertensives with BRS ≤ 5ms/mmHg have significantly increased IMT CCA. The principal result of this study showed that BRS and carotid IMT in relatively low-risk hypertensives and SHNBP could identify subjects at higher cardiovascular risk.