Vol 7, No 2 (2003)
Original paper
Published online: 2003-03-24
Arterial Hypertension and Other Atherosclerotic Risk Factors in Patients Referred for Elective Coronary Angiography to Confirm Significant Coronary Artery Stenosis
Nadciśnienie tętnicze 2003;7(2):79-85.
Abstract
Background Arterial hypertension is one of the most important risk factors of atherosclerosis and related diseases.
It is associated with increased risk of coronary artery disease (CAD) and acute cardiovascular events. The aim of our
study was to investigate potential association between arterial hypertension and survived myocardial infarction and extent of coronary atherosclerosis in patients with significant coronary atherosclerosis confirmed by angiography.
Material and methods The study was performed in 873 consecutive patients (740 male and 133 female, mean age 57 ± 11 years) with stable, angiographically confirmed CAD, defined as at least 50% stenosis of at least one epicardial coronary artery. The extent of CAD was determined on the basis of the number of main epicardial coronary arteries with at least 50% luminal stenosis and by calculating a coronary atherosclerosis score based on the number of significantly stenosed coronary arteries and the severity of stenosis.
Results The prevalence of arterial hypertension was 49% in our study group. Arterial hypertension was significantly more frequent in female patients in comparison to males 60.2% and 46.5%, p < 0.01, respectively. There was no significant association between arterial hypertension and survived myocardial infarction (OR 0.71, 95% CI 0.54–1.03) and extent of coronary atherosclerosis (OR 0.83, 95% CI 0.62–1.12). However, significantly increased risk of multiple vessel disease was observed in hypertensive patients older than 60 years of age (OR 2.18, 95% CI 1.33–3.58, p < 0.01). The body mass index (BMI), fasting plasma glucose level and incidence of diabetes were significantly increased in hypertensive subjects in comparison to normotensives.
Conclusions Arterial hypertension is associated with more severe coronary atherosclerosis in elderly patients. The elements of metabolic syndrome are present in hypertensive patients and can play an important role in increasing the risk of cardiovascular events in this group.
Material and methods The study was performed in 873 consecutive patients (740 male and 133 female, mean age 57 ± 11 years) with stable, angiographically confirmed CAD, defined as at least 50% stenosis of at least one epicardial coronary artery. The extent of CAD was determined on the basis of the number of main epicardial coronary arteries with at least 50% luminal stenosis and by calculating a coronary atherosclerosis score based on the number of significantly stenosed coronary arteries and the severity of stenosis.
Results The prevalence of arterial hypertension was 49% in our study group. Arterial hypertension was significantly more frequent in female patients in comparison to males 60.2% and 46.5%, p < 0.01, respectively. There was no significant association between arterial hypertension and survived myocardial infarction (OR 0.71, 95% CI 0.54–1.03) and extent of coronary atherosclerosis (OR 0.83, 95% CI 0.62–1.12). However, significantly increased risk of multiple vessel disease was observed in hypertensive patients older than 60 years of age (OR 2.18, 95% CI 1.33–3.58, p < 0.01). The body mass index (BMI), fasting plasma glucose level and incidence of diabetes were significantly increased in hypertensive subjects in comparison to normotensives.
Conclusions Arterial hypertension is associated with more severe coronary atherosclerosis in elderly patients. The elements of metabolic syndrome are present in hypertensive patients and can play an important role in increasing the risk of cardiovascular events in this group.
Keywords: arterial hypertensioncoronary artery diseaserisk factorsatherosclerosis