Arterial stiffness and cerebral lesions in patients with arterial hypertension and atherosclerosis

Objective. To assess arterial stiffness (AS) and to determine its influence on cerebral damage in patients with arterial hypertension (AH) and atherosclerosis. Design and methods. The 1^st group included 60 patients with cerebrovascular disorders: 23 with chronic vascular encephalopathy (CVE) and 37 with post-stroke lesions. 2^nd group consisted of 23 patients with cardiovascular risk factors without any cerebrovascular disturbances. AS was assessed by 24-hour bifunctional ECG and blood pressure monitoring (data were processed by the computer program «Vasotens», MnSDP-3, BPLab, «Pyotr Telegin», Russia). Results. In both groups AS parameters did not differ in the groups considering matched main vascular risk factors. But AS was higher in patients with CVE. There was a significant association between increased AS and focal cerebral (particularly multiple deep lacunar lesions) or diffuse (leucoaraiosis) lesions and subarachnoid space and ventricular system expansion visualized by brain magnetic resonance imaging. Conclusion. Thus, increased AS may be considered as an independent factor of cerebral damage (including silent lesions) in patients with AH and atherosclerosis.

arterial stiffness, silent cerebral lesions, arterial hypertension, cerebrovascular disorders

1. Бойцов С.А. Сосуды как плацдарм и мишень артериальной гипертонии // Актуальные вопросы болезней сердца и сосудов. - 2006. - № 1. - С. 35-40.

2.

3. Орлова Я.А., Агеев Ф.Т. Жесткость артерий как интегральный показатель сердечно-сосудистого риска: физиология, методы оценки и медикаментозной коррекции // Сердце. - 2006. - № 2. - С. 65-70.

4.

5. Орлова Я.А., Агеев Ф.Т. Жесткость артерий как предиктор сердечно-сосудистых осложнений при ИБС // Терапевт. арх. - 2010. - № 1. - С. 71-79.

6.

7. Laurent S., Katsahian S., Fassot C. et al. Aortic stiffness is independent predictor of fatal stroke in essential hypertension // Stroke. - 2003. - Vol. 34, № 5. - P. 1203-1206.

8.

9. Laurent S., Cockcroft J., Van Bortel L. et al. Expert consensus document on arterial stiffness: methodological issues and clinical applications // Eur. Heart J. - 2006. - Vol. 27, № 21. - P. 2588-2605.

10.

11. Hansen T.W., Staessen J.A., Torp-Pedersen C. et al. Ambulatory arterial stiffness index predicts stroke in a general population // J. Hypertens. - 2006. - Vol. 24, № 11. - P. 2247-2253.

12.

13. Mattace-Raso F.U., van der Cammen T.J., Hofman A. et al. Arterial stiffness and risk of coronary heart disease and stroke: the Rotterdam Study // Circulation. - 2006. - Vol. 113, № 5. - P. 657-663. 8.

14.

15. Диагностика и лечение артериальной гипертензии. Российские рекомендации (Третий пересмотр) // Кардиоваск. терапия и профилактика. - 2008. - Т. 7, № 6, прил. 2. - С. 1-32.

16.

17. Mancia G., de Backer G., Dominiczak A. et al. 2007 Guidelines for the management of arterial hypertension. The task force for the management of arterial hypertension of the European Society of Hypertension (ESH) and of the European Society of Cardiology (ESC) // J. Hypertens. - 2007. - Vol. 25, № 6. - P. 1105-1187.

18.

19. Шмидт Е.В. Классификация сосудистых поражений головного и спинного мозга // Журн. невропатологии и психиатрии им. С.С. Корсакова. - 1985. - № 9. - С. 1281-1288.

20.

21. Никитин Ю.М., Труханов А.И. (ред.) Ультразвуковая доплеровская диагностика сосудистых заболеваний. - М.: ВИДАР, 1998. - 432 с.

22.

23. Liao D., Cooper L., Cai J. et al. The prevalence and severity of white matter lesions, their relationship with age, ethnicity, gender, and cardiovascular disease risk factors: the ARIC Study // Neuroepidem. - 1997. - Vol. 16, № 3. - P. 149-162.

24.

25. Kearney-Schwartz A., Rossignol P., Bracard S. et al. Vascular structure and function is correlated to cognitive performance and white matter hyperintensities in older hypertensive patients with subjective memory complaints // Stroke. - 2009. - Vol. 40, № 4. - P. 1229-1236.

26.

27. Hatanaka R., Obara T., Watabe D. et al. Association of arterial stiffness with silent cerebrovascular lesions: The Ohasama Study // Cerebrovasc. Dis. - 2011. - Vol. 31, № 4. - P. 329-337.

28.

29. Wilkinson I.B., Qasem A., McEniery C.M., Webb D.J., Avolio A.P., Cockcroft J.R. Nitric oxide regulates local arterial distensibility in vivo // Circulation. - 2002. - Vol. 105, № 2. - P. 213-217.

30.

31. London G.M. Cardiovascular disease in chronic renal failure: pathophysiologic aspects // Semin. Dial. - 2003. - Vol. 16, № 2. - P. 85-94.

32.

33. Feugeas M.C.H., De Marco G., Peretti I.I. et al. Age-related cerebral white matter changes and pulse-wave encephalopathy: observations with three-dimensional MRI // Magn. Reson. Imaging. - 2005. - Vol. 23, № 9. - P. 929-937.

34.

35. Breithaupt-Grogler K., Belz G.G. Epidemiology of arterial stiffness // Pathol. Biol. (Paris). - 1999. - Vol. 47, № 6. - P. 604-613.

36.

37. Benetos A., Adamopoulos C., Bureau J.M. et al. Determination of accelerated progression of arterial stiffness in normotensive subject and treated hypertensive subject over a 6-year period // Circulation. - 2002. - Vol. 105, № 10. - P. 1202-1207.