ARTERIAL WALL CONDITION IN WOMEN WITH HYPERTENSION AND POSTMENOPAUSAL OSTEOPOROSIS

Abstract

Objective: The aim of the study was to investigate the indices of arterial stiffness and central aortic pressure in women with hypertension in combination with osteoporosis. Design and method: The study included 68 females (mean age 62.7±3.8 years) with hypertension, grade 2 in postmenopause including 35 females with osteoporosis (group 1) and 33 females without signs of osteoporosis (group 2) according to osteodensitometry investigation. The control group consisted of 20 healthy females (mean age 61.3±3.5 years). Before the study, the patients did not receive regular antihypertensive drugs and hormone replacement therapy. In addition to conventional studies the levels of calcium, phosphorus, alkaline phosphatase, deoxypyridinoline, parathyroid hormone, 25(OH) vitamin D, osteocalcin, C-terminal telopeptide of type I collagen in blood were determined. Fracture risk assessment (FRAX), daily blood pressure monitoring, applanation tonometry and dual-energy X-ray absorptiometry were performed. Results: It was found that in group 1 the levels of office systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 3.7% and 4.9% (p<0.05) higher than in group 2. According to the data of daily BP monitoring a more pronounced increase of mean daily SBP and DBP by 4.1% and 6.6% (p<0.05) was observed in group 1 in comparison to group 2. Indicators of pressure load according to the time index of hypertension by SBP and DBP were significantly higher by 21.7% and 25.4% during the day and 22% and 18.2% at night (all p<0.05). In patients of group 1 an increase in the aortic augmentation index of wave reflection (Aix) and the augmentation index of wave reflection, adjusted for heart rate (AIx @ HR 75) by 26.6% and 29.8% compared to patients of group 2 respectively, was revealed. It was found that in group 1, compared with the control group and group 2, an increase in pulse wave velocity by 37.2% and 26.4% respectively was detected. Conclusions: It was found that in patients with hypertension in combination with postmenopausal osteoporosis, according to office, daily monitoring and applanation tonometry, blood pressure levels and arterial stiffness parameters were significantly higher than in patients with hypertension without osteoporosis.