Assessment of arterial remodeling in men with arterial hypertension: the role of instrumental and laboratory markers

Introduction. Early detection of arterial remodeling in patients with arterial hypertension (AH) allows to timely activate prevention of complications and implement a personalized approach to therapy.

Objective. To evaluate arterial remodeling using instrumental and laboratory markers in men with AH of I and II grade.

Materials and methods. The study included 207 men aged 30-49 years, of whom 67 were healthy individuals and 140 patients with AH, who were divided into 6 groups depending on age and grade of AH. Instrumental assessment of arterial remodeling was performed using volumetric sphygmography with VaSera VS-1500N sphygmograph, duplex scanning of the brachiocephalic arteries with SonoScape S20Exp ultrasound device and rheography to assess the speed of pulse wave propagation with Impecard-M computer rheograph. The content of endothelin-1, transforming growth factor β1, type IV collagen in blood was determined by enzyme immunoassay.

Results. At the age of 30–39 years, CAVI and vascular age were higher in patients with AH grade II compared with both practically healthy men (p=0.01 and p=0.003 respectively) and patients with AH grade II (p=0.002 and p=0.004 respectively), while at the age of 40–49 years, CAVI and vascular age were higher in patients with AH grade II only when compared with basically healthy men (p=0.04 and p=0.04 respectively). The augmentation index and intima-media complex thickness at the age of 30–39 years were higher in patients with AH grade II (p=0.004 and p=0.03) compared to healthy men; at 40–49 years of age, the augmentation index did not differ in the studied groups, while the intima-media thickness in patients with AH grades I and II was higher than in healthy men (p=0.04 and p=0.00001 respectively). The incidence of atherosclerotic plaques in brachiocephalic arteries in 40–49 years old men was 46.2 % in patients with AH grade I and 43.8 % in patients with AH grade II. The content of transforming growth factor β1 and type IV collagen was comparable in the studied groups.

Conclusion. Patients with AH grade I and II exhibit different phenotypes of arterial remodeling. Men with AH grade II have the most pronounced changes in parameters during instrumental examination.

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