Original Article   

Panminerva Medica 2022 Jun 28

DOI: 10.23736/S0031-0808.21.04608-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

The operation of carotid endarterectomy: is it an effective method of treatment of arterial hypertension?

Olga GERMANOVA ¹ ✉, Giuseppe GALATI ², Alexey VACHEV ³, Andrey GERMANOV ⁴, Giuseppe BIONDI-ZOCCAI ⁵

¹ International Centre for Education and Research in Cardiovascular pathology and Cardiovisualization, Samara state medical university, Samara, Russia; ² Heart failure unit and division of Cardiology, Cardiothoracic and vascular department, San Raffaele hospital and scientific institute, Milan, Italy; ³ Department of Faculty surgery, Samara state medical university, Samara, Russia; ⁴ Department of Propedeutical therapy, Samara state medical university, Samara, Russia; ⁵ Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University, Rome, Italy

AIM: To establish the relationship between AH and hemodynamically significant atherosclerotic stenosis of carotid bifurcation and study the effect of carotid endarterectomy (CEA) on the course of AH.
MATERIALS AND METHODS: In our investigation we included 320 patients: 243 (75,9%) men and 77 (24,1%), the mean age - 59,6 ± 8,2. All patients underwent CEA operation. Patients were divided into groups: I (320) - before CEA surgery and AH; II (320) - the same patients after CEA operation. All patients underwent laboratory tests, ECG, chest X-ray, ultrasound of the kidneys, thyroid gland, computer tomography (CT) of adrenal glands, of the brain, echocardiography, ultrasound or angiography of the renal arteries. Before and after the CEA, there were made Doppler ultrasound of brachiocephalic arteries, 24 hours blood pressure (BP) monitoring. Additional visits were made by 73 patients in 3, 6 and 12 months after the CEA.
RESULTS: Most of the patients had significant decrease of BP in the postoperative period, which was observed in 257 (80,3%) patients on days 2-7, in 58 (18,1%) - did not change significantly, and only 5 (1,6%) had the increasing of BP. In 29 (39,7%) patients 1 year after CEA, there was no need to use antihypertensive therapy due for the normalization of BP after the surgery.
CONCLUSIONS: It is necessary to highlight the cerebrovascular AH into a separate form of the secondary AH. The CEA has prominent, stable anti-hypertensive effect on these patients.

KEY WORDS: Blood pressure; Carotid endarterectomy; Secondary arterial hypertension