PROSTATE SPECIFIC ANTIGEN LEVELS WITHIN NORMAL RANGE ARE ASSOCIATED WITH ARTERIAL STIFFNESS IN ESSENTIAL HYPERTENSIVE PATIENTS: PP.31.234

Abstract

Objective: Prostate specific antigen (PSA) is an established marker for prostate hypertrophy and cancer. PSA within normal limits reflects both gland hypertrophy and specific inflammation. The aim of the present study was to investigate whether PSA values, within normal levels, are associated with arterial stiffness independently of subclinical inflammation in patients with essential hypertension. Design and Methods: The study comprised 150 consecutive male patients (mean age 60 years) with uncomplicated never-treated essential hypertension. All patients underwent a complete clinical and laboratory evaluation, including PSA levels. Aortic stiffness and arterial wave reflection assessment was made by using carotid femoral (PWVc-f) pulse wave velocity and aortic augmentation index corrected for heart rate (Aix75). Patients with prostate cancer or benign prostate hyperplasia (PSA>4ng/ml) were excluded from the study. Results: PSA levels were positively associated to PWVc-f (r = 0.426, p < 0.001), AIx75 (r = 0.264, p=0.001) and hsCRP (r = 0.376, p < 0.001). When PSA values were grouped in quartiles, patients in the higher quartile presented with higher PWVc-f (p < 0.00001), AIx75 (p < 0.001) and hsCRP (p < 0.001) values. In multivariate analysis after adjustment for the factors affecting arterial stiffness, PSA remained significant determinant of PWVc-f values (R2 = 0.405, p<0.001), while hsCRP was non-significant (p = 0.09). Conclusions: The present study points to an association of PSA levels to aortic stiffness in untreated essential hypertensive males. Potential causal relationships between PSA and arterial stiffness remain to be further explored.