CORRELATION BETWEEN GRADE OF HYPERTENSION AND EXTENSION OF CORONARY ARTERY DISEASE IN HYPERTENSIVE PATIENTS – CROSS-SECTIONAL STUDY FROM CENTRAL ROMANIA

Abstract

Objective: The prevalence of coronary artery disease (CAD) is more susceptible to develop in hypertensive patients with multiple associated cardiovascular risk (c-v) factors. We hypothesized that the number and severity of coronary lesions is directly related to hypertension grade and concomitant presence of different c-v risk factors. Design and method: Between September 2015 to February 2016, 283 hypertensive patients (mean age 63+/−9.039 y.o.) performed invasive evaluation of coronary arterial tree. Clinical indications were: ischemic heart disease, cardiomyopathies, valvular heart disease and rhythm and conduction disturbances. An observational, cross-sectional study was conducted; clinical and imaging results were computed. Hypertensive patients were stratified to 3 grades according to 2013 ESH/ESC guidelines for the management of arterial hypertension (HT). Patients were divided according to the number of coronary arteries involved: single, double, triple vessel CAD. Results: With regard to hypertension grades correlated with CAD, in our study 3.1%(9) pts were included in grade 1 HT, 53.0% (150) grade 2 HT and 19.08% (54) patients were diagnosed with HT grade 3. No significant CAD was described in 70 pts (24.73%) presenting grades 1, 2 and 3 HT. Out of 190 male and 93 female hypertensive patients, 61.13% (173 pts) had significant CAD (>50% reference vessel diameter reduction). Single vessel disease was present in 88.8% of grade 1 hypertensive patients, and triple vessel disease was identified in 29.3% of patients presenting hypertension grade 2 compared to 24.0% in grade 3 hypertensive patients. Correlation between grade of HT and severity of CAD (number of affected vessels) was studied using chi-square test, demonstrating a very strong statistically correlation (p < 0.0001). Conclusions: Not optimally treated high grades of hypertension will increase the number of patients requiring different procedures of myocardial revascularization. Extended research on risk factors predisposing to coronary artery disease and their synergism, among them high blood pressure, is necessary in order to reduce the global burden of cardiovascular disease.