Reena Sharma, Fokeer
(2011)
A comparison of arterial stiffness in hypertensive
patients with controlled and uncontrolled
systolic blood pressure using pulse wave velocity
measurement.
Masters thesis, Pusat Pengajian Sains Perubatan.
Abstract
Arterial stiffness is an important predictor of increased
cardiovascular events. It has been shown to be strongly positively correlated with
systolic blood pressure. The pulse wave velocity (PWV) is a non invasive measure
of arterial stiffness and can reliably predict the degree of arterial stiffness in
hypertensive patients who are asymptomatic of cardiovascular disease but who are
at risk of developing ischemic heart disease. In hypertensive patients, uncontrolled
systolic blood pressure is associated with a higher pulse wave velocity, which
corresponds to a greater degree of arterial stiffness compared to hypertensive
subjects with well controlled systolic blood pressure. Therefore those patients with
uncontrolled systolic blood pressure and increased arterial stiffuess are at higher
risk of developing cardiovascular events. The objective of this study was to determine a difference in the pulse
wave velocity (PWV) between controlled and uncontrolled systolic blood pressure
(SBP) in hypertensive subjects at Hospital Universiti Sains Malaysia (HUSM). This is a cross sectional study. 84 hypertensive patients were recruited.
They were equally divided into 2 groups (controlled and uncontrolled systolic
blood pressure) based upon the systolic blood pressure readings observed over the
previous 6 months. The pulse wave velocity was determined using standard
methods, using the Sphygmocor ® machine, which is an automated tonometer.
The right carotid and right femoral pulse waves were the sites used in this study to
determine the pulse wave velocity.(W-C Yu eta/., 2008) There was no significant difference in the baseline characteristics between
the two groups, except for the systolic blood pressure. It was observed that there
was a statistically significant difference in the PWV in the uncontrolled SBP
group (12.9 m/s) compared to the PWV in the controlled SBP group((9.9m/s,
p<O.OOl). This study has shown that pulse wave velocity is higher in
hypertensive patients with an uncontrolled systolic blood pressure. Hence pulse
wave velocity may be considered to be a useful non invasive tool for early
screening of cardiovascular disease in hypertensive patients, since arterial stiffness
is a proven surrogate marker for future cardiovascular events.
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