Psychological determinants of target organ damage in hypertensive patients: Focus on Pulse Wave Velocity and depression

Andrea Greco, Alessandro Maloberti, Marisa Varrenti, Ilaria Bassi, Enrico Piccinelli, Francesco Panzera, Stephan Laurent, Pierre Boutouyrie, Massimo D'Addario, Anna Maria Annoni, Patrizia Steca, Cristina Giannattasio
2017 Artery Research  
Methods: Cross-sectional, observational study in 171 consecutive, treatment-naïve subjects derived to a Hypertension Unit with suspected hypertension. Standard echocardiography, ECG, carotid ultrasound and laboratory tests were performed. Results: Mean age was 49.7 years, 57.3% were women. Reproducibility: Mean differences (AESD of the difference (SDD)) between duplicate SC and MG PWV measurements were non-significant. Agreement: cfPWV0.8 yielded the highest PWV values (8.17 AE 1.6 m/s),
more » ... AE 1.6 m/s), followed by cfPWVsub (7.98 AE 1.7 m/s), supPWVestim (7.83 AE 1.7 m/s) and sitPWVestim (7.80 AE 1.6 m/s). We observed significant mean differences only between cfPWV0.8 and all other PWV measures: with cfPWVsub (0.23 m/s, p Z 0.001), with sitPWVestim (0.39 m/s, p Z 0.001) and with supPWVestim (0.38 m/s, p Z 0.002). No significant correlation was found between the mean and the difference for PWV in any comparison. Association with cardiac damage was highest with cfPWVsub, supPWVestim and sitPWVestim were more closely related to carotid damage, though differences were not significant. Conclusions: SC and MG showed similar and acceptable reproducibility. SC and MG were interchangeable only using subtracted distance (cfPWVsub), while direct distance x 0.8 showed significantly higher PWV values. Association to TOD was significant and similar between SC and MG. Background: Cognitive impairment and elevated arterial stiffness are described in arterial hypertension (AH), but its correlations are not well studied. Objectives: To study the cognitive function at different domains and arterial properties in patients with AH stage 1 to 3 compared to normotensives and to evaluate the correlations between these variables. Methods: We evaluated 71 normotensives (52 AE 14 yrs, 47% male, 65% white) and 150 patients with stage 1e3 AH (52 AE 12 yrs, 45% male, 70% white) under treatment. The global cognitive function was assessed by Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA).A validated battery of neuropsychological tests (NPE) assessed the main cognitive areas: memory, language, visuospatial ability, executive function, attention. Pulse wave velocity (PWV) was measured by Compliorâ device. Carotid properties were assessed by radiofrequency ultrasound (WTSâ). Central arterial pressure and augmentation index (AIx) were obtained using applanation tonometry (Sphygmocorâ). Results: Mean BP of the normotensive group (122.1 AE 8/76.7 AE 7 mmHg) was significantly lower than hypertensive patients (135.2 AE 13/83.3 AE 10 and 149.9 AE 29/91.5 AE 16 mmHg). Severe HTN group had worse performance in cognitive evaluation either by MMSE (26.8 AE 2.1 vs 27.4 AE 2.1 vs.
doi:10.1016/j.artres.2017.10.082 fatcat:pqd36tqodnayfl3rhzzfme547e