Interrelation between ambulatory blood pressure indices and the lesions of the common carotid arteries in hypertensive patients at early post-stroke period

Abstract

Objective. To study the variability of blood pressure (BP) based on ambulatory BP monitoring and its correlation with the state of the walls of the carotid arteries in hypertensive post-stroke patients. Design and methods. Anthropometry, fasting blood glucose tests and lipid profile, BP monitoring, doppler ultrasound of the carotid arteries were performed in 90 subjects. Results. There is a positive correlation between indicators of ambulatory BP monitoring and the state of the walls of the carotid arteries, in particular, between daytime variability of systolic BP (SBP) and the diameter of the common carotid arteries (R = 0,5; p < 0,05). A negative correlation between nocturnal SBP variability and blood flow velocity in the common carotid arteries (R = –0,5; p < 0,05) and a positive relation between daytime time index of SBP and resistivity index in external carotid arteries (R = 0,61; p < 0,05) were determined. Mean ambulatory SBP level is directly correlated with the resistivity index of the internal carotid arteries and blood flow velocity in the common carotid arteries (R = 0,52; p < 0,05). There is a correlation between the degree of nocturnal SBP reduction and intima-media thickness (R = –0,62; p < 0,001). Correlation was determined between the degree of nocturnal diastolic BP reduction and blood flow velocity in the common carotid arteries (R = 0,65; p < 0,05). Conclusions. There is a violation of circadian BP profile in all hypertensive patients after stroke, despite achieved target levels of BP. There is a correlation between the severity of atherosclerotic lesions of common carotid arteries and lipid metabolism, age, as well as with ambulatory BP indices. Thus, 24-hour BP parameters should be considered when evaluating the effectiveness of antihypertensive therapy in hypertensive post-stroke patients.