INVESTIGADORES
OTERO-LOSADA Matilde Estela
congresos y reuniones científicas
Título:
ARTERIAL STIFFNESS, BLOOD PRESSURE VARIABILITY, ATHEROSCLEROTIC PLAQUE AND MICROALBUMINURIA IN ELDERLY ADULTS
Autor/es:
MILEI J; SANCHEZ GELOS DIEGO F; GOMEZ-LLAMBI H.; OTERO-LOSADA M
Lugar:
London
Reunión:
Congreso; 22nd European Meeting on Hypertension and Cardiovascular Protection; 2012
Institución organizadora:
European Society of Hypertension
Resumen:
OBJECTIVE.
To evaluate the relation of carotid wall morphology and microalbuminuria (Alb) with
arterial stiffness, blood pressure variability (BPVar) and other cardiovascular
parameters in elderly subjects, following our previous observations in relation
with blood pressure morning surge and target organ damage.
DESIGN
AND METHODS. Fifty nine patients >65 years old (44 women, 74±1 years and 15
men, 76±2 years) were enrolled. Ambulatory BPVar was estimated as the standard
deviation of the 24-h mean (systolic and diastolic) blood pressure recording.
Pulse wave velocity (PWV) was obtained from the pressure values of digitized
carotid and femoral arteries. Eco-Doppler from heart and supra aortic vessels
and microalbuminuria (Alb) were also assessed. Data was evaluated by bivariate
correlation analysis using the Pearson's coefficient (r).
RESULTS.
Microalbuminuria and BPVar showed differential changes according with the
degree of carotid damage. 1) The presence of atherosclerotic plaque was related
to Alb increase (16% explained variance, r=0.394, p<0.01, n=39). The
strength of plaque-Alb association was dependent on the diagnosis of
hypertension (22% explained variation, r=0.468, p < 0.01, n=28
hypertensives), nocturnal dipping (32% explained variance, r=0.562, p<0.007,
n=22 dippers) and sex (36% explained variance, r=0.600, p<0.001, n=28
women). 2) BPVar was directly related to carotid wall thickening (13% explained
variance, r=0.363, p<0.01, n=49). This association varied according with
diagnosis of hypertension (19% explained variation, r=0.431, p<0.008, n=37
hypertensives) and dipping condition (29% explained variation, r=0.537,
p<0.005, n=26 dippers). 3) A direct relationship was found between PWV and
Alb (14% explained variation, r=0.352, p<0.03, n=37) and increased after
controlling for carotid status (17% explained variance, r=0.415, p<0.01,
n=34). Actually PWV-Alb association was particularly strong in carotid
plaque-bearing patients (38% explained variance, r=0.616, p<0.01, n=15).
CONCLUSION.
These results suggest that arterial wall pathology increases the likelihood of
abnormal glomerular filtration according with nocturnal dipping and diagnosis
of hypertension. Integration of the pathophysiological mechanisms involved in
age-dependent progressive kidney function decline with those of atherogenesis
and hypertension has still a long way to go.