Abstract 4858: Is Brachial Artery Diameter an Early Index of Organ Damage in Hypertension?

Abstract

Objectives: Arteries can enlarge in response to a variety of hemodynamic and non-hemodynamic stimuli. The role of vascular remodeling in atherosclerosis-free arteries in hypertension is poorly understood. We investigated whether brachial artery diameter (BAD), an index of vascular remodeling, is increased in hypertensive patients, and has a relationship with left ventricular (LV) mass, an important marker of target-organ damege in hypertension. Methods: 463 never-treated subjects with uncomplicated essential hypertension (283 men, 180 women; age 48+/−11 years, office blood pressure 155/96+/−17/9 mmHg) underwent M-mode echocardiography, 24-h BP monitoring, and ultrasound assessment of end-diastolic non-dominant BAD. 96 healthy normotensive subjects (40% women) served as controls. Analyses were performed separately in men and women. Results: BAD had significant direct associations with age, male sex, systolic blood pressure and body mass index. BAD was larger in hypertensive subjects than in normotensive controls (4.62+/−0.8 vs 4.48+/−0.7 mm, p=0.02). In hypertensive subjects, age-adjusted BAD values were higher in subjects with LV hypertrophy (LV mass >51 g/m2.7; 4.46+/−0.6 vs 4.04+/−0.6 mm in women, 5.13+/−0.7 vs 4.81+/−0.7 mm in women, both p<0.0001). In sex-specific multiple linear regression analyses (Table), BAD predicted LV mass index in both men (beta=0.17, p=0.003) and women (beta=0.13, p=0.043), independently from the effects of age, 24-hour BP and body mass index (all p<0.05). Conclusion: Diameter of the brachial artery is increased in untreated hypertensive subjects. In hypertension, larger brachial artery diameter is associated with left ventricular hypertrophy, and this relation is partly independent from the effect of common predictive factors. Brachial artery diameter is a potential early marker of organ damage in hypertension.