PP.18.11

Abstract

Objective: The aim of our study is to find out the proper method to evaluate different target organ damage in hypertensive patients, with or without chronic kidney disease (CKD). We subjected our population to non-mydriatic digital fundus oculi examination, pulse wave velocity (PWV) and echocardiography (Echo) to estimate arterioral narrowing of retinal vessels, arterial stiffness and Left Ventricular Hypertrophy (LVH) or Remodelling (LVR). Design and method: We studied 52 hypertensive patients divided in two groups according to the presence (Group A, 24 patients) or absence (Group B, 28 patients) of CKD. Both groups underwent non-mydriatic digital fundus oculi examination, carotid-femoral PWV, in order to assess small and big vessels damage and an Echocardiographic study for detection of cardiac damage. The parameters we considered were Arteriolar-Venular Ratio (AVR) to evaluate retinal vessels, femoral PWV to estimate arterial stiffness and Left Ventricular Myocardial index (LVMi) and h/r index to determine left ventricular hypertrophy. Results: Both groups showed abnormal values of PWV, but significantly higher in Group A vs. Group B (13.04 ± 1.284 vs 9.78 ± 0.491, p = 0.0157). AVR values were abnormal only in Group A, with a significant difference respect to Group B (0.76 ± 0.007 vs 0.82 ± 0.010, p = 0.0000). In the Echo examination, no statistically significant alterations were found between the two groups (LVMi 100.04 ± 3.920 vs 93.42 ± 3.069, p = 0.1839; h/r 0.40 ± 0.009 vs 0.41 ± 0.010, p = 0.5162). Conclusions: Our study shows that there is a difference in target organ damage in hypertensive patients with CKD, compared to its absence, it affects particularly small and big vessels while there is no evidence of significant heart damage. Moreover patients without CKD show major frequence of LVR. Therefore the use of non-mydriatic digital fundus oculi examination and PWV should always be considered to properly assess the target organ damage.