Renal function, rigidity of magistral arteries and vascular age in patients with arterial hypertension and type 2 diabetes mellitus

Abstract

The aim : to evaluate the renal function in conjunction with the rigidity of the magistral arteries and the vascular age in patients with arterial hypertension (AH) and diabetes mellitus (DM) type 2. Patients and methods . 280 hypertensive patients 45-65 years old with unachieved target blood pressure (BP) values were divided into two groups comparable by clinical and demographic characteristics: the 1 (main) group included patients with AH and DM type 2, the 2 (control) group included patients with AH without DM type 2. Clinical examination, assessment of the renal function, rigidity of the magistral arteries and vascular age were conducted. Results. A significant increase in the level of albuminuria (AU) - 223.4 [91.4; 329.2] vs 26.4 [8.88; 65.0] mg/g, and β2-microglobulins in the urine (0.445 [0.300; 0.612] vs 0.228 [0.114; 0.398] mg/l) and a statistically significant decrease in glomerular filtration rate (GFR) in patients of group 1 compared with patients of group 2 (63.0 [55.0; 73.0] vs 72 [61.5; 88] ml/min/1.73 m 2 ) were noted. The pulse wave velocity through the vessels of the elastic and muscular types (PWVe. and PWVm.) were higher in patients with AH and DM type 2 than in patients with AH without comorbid pathology (10.2 [9.0; 12.2] vs 9,0 [8.0; 10.7] m/s and 9.1 [7.9; 10.4] vs 8.4 [7.5; 9.6] m/s, respectively, p<0.05 ). The vascular age was significantly higher in the main group than in the control group (69.0 [64.0; 73.0] vs 64.0 [57.0; 71.0] years, respectively). We revealed highly reliable relationship between renal function, the rigidity of large vessels and vascular age. Conclusion. The study showed a significant progressive deterioration of the renal function and the elasticity of the vascular wall of the magistral arteries, the growth of the vascular age, an increase in the 5-year risk of cardiovascular complications in hypertensive patients with type 2 diabetes compared with patients with “isolated” AH with comparable office blood pressure in the studied groups.