PRESENCE OF ASYMPTOMATIC PERIPHERAL ARTERY DISEASE AMONG HYPERTENSIVE PATIENTS WITH CORONARY DISEASE

Abstract

Objective: The aim of the study is to evaluate the presence of asymptomatic peripheral artery disease among hypertensive patients with coronary disease and its association with the severity of coronary artery disease. Design and method: The study enrolled 150 examinees divided into two groups. The patients with hypertension and coronary disease constituted the first group (n = 100); the second group consisted of the healthy examinees–control group (CG, n = 50). For all patients there was determined: presence of risk factors for cardiovascular disease (hypertension, hyperlipidemia, smoking, diabetes, obesity, age), laboratory analyses, anthropometric measurements, ankle–brachial index (ABI) and coronarography. Results: In the first group the average number of atherosclerosis involved coronary blood vessels was 2.22 ± 0.81, in 46.0% observed in three blood vessels, in 30.0% in two, in 24.0% in one vessel. The average value of ABI in CG was significantly higher (p < 0.01). All controls had ABI in the normal range. Pathological value ABI was found in 59% patients in I group, 41,0% had reduced ABI, 18.0% higher values. The value of ABI was lowest in patients with three blood vessels affected and significantly lower than in those with one affected blood vessel (p < 0.01). In patients with a single blood vessel affected, it was more common to have normal and increased ABI compared to those with three (p < 0.05) and much more rarely lower ABI values compared to those with two and three (p < 0.001) affected blood vessels. With each increase of ABI, valued by one unit of measurement, the number of involved blood vessels dropped by 1.298, p < 0.01. As the most important factors associated with the number of coronary blood vessels affected by atherosclerosis, multivariate regression analysis singled out ABI, CV risk score and waist-hip ratio. The multivariate analysis of variance indicates significant individual effects of the ABI index (F = 2.71, p < 0.05), SCORE risk (p < 0.001) and age (p < 0.01) per set of percentages of stenosis of all single coronary arteries. Conclusions: More than half of coronary patients with hypertension have asymptomatic peripheral artery disease. Our results have shown that reduced ABI were in correlation with the severity of coronary disease assessed based on the number of affected coronary blood vessels.