Author/Editor		Eržen, Barbara; Gradišek, Primož
Title		Spremembe žilne stene in sestave krvi pri arterijski hipertenziji
Translated title		Arterial hypertension - induced changes in blood vessels and blood structure
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 35, št. 2
Publication year		1996
Volume		str. 163-95
Language		slo
Abstract		Arterial hypertension is one of the major risk factor predisposing to atherosclerosis. Since elevated blood pressure is part of endocrine metabolic syndrome, hypertensive patients have many other risk factors predisposing to cardiovascular disease. Early detection of changes accompanying atherosclerosis is of paramount importance, as preventive measures are most successful if taken in the early stage of the disease. The study was focused on changes in arterial walls and in altered blood structure interfering with normal flow of blood. Thickness of the intima and media of the carotid arteries (IMT), and flow-dependent vasodilation and plasma viscosity were determined. IMT was measured by B-mode ultrasound at three different sites, while flow - dependent vasodilation was evaluated by the provocation test performed on the brachial artery. Blood samples were taken for determinations of plasma viscosity and atherogenic factors. We studied 28 hypertensives treated with ACE inhibitors (mean age 55,1 years), and 22 healthy subjects (mean age 54,2 years) with no risk factors for atherosclerosis. In the group of hypertensive patients, the mean IMT determined at all three segments of the carotid artery was significantly greater then in the control group (0,81 +- 0,7 to 0,62 +- 0,07 mm, p < 0,0001). Also atherosclerotic lesions were more common in the group of hypertensives. There was a direct relationship between IMT and duration of elevated blood pressure, age, greater waist - hip ratio and increased fasting glucose and triglyceride levels. The presence of atherosclerotic plaque was associated with higher iron and lipoprotein a concentrations. (Abstract truncated at 2000 characters.)
Summary		Arterijska hipertenzija je pomemben dejavnik tveganja za aterosklerozo. Bolniki z arterijsko hipertenzijo imajo poleg povišanega krvnega tlaka še veliko drugih dejavnikov tveganja, saj je povišan krvni tlak del presnovno endokrinega sindroma. Zato so ti bolniki še toliko bolj ogroženi. Pomembno je zgodnje odkrivanje sprememb, ki spremljajo aterogenezo, saj so preventivni ukrepi v tem obdobju najuspešnejši. Zanimale so nas predvsem spremembe žilne stene in spremembe v sestavi krvi, ki vplivajo na hemoreologijo. Določani smo debelino intime in medije karotidnih arterij, relaksacijsko sposobnost perifernih arterij in viskoznost plazme. Debelino intime in medije smo merili z ultrazvočno preiskavo na način B na treh mestih karotidne arterije; dilatijsko sposobnost perifernih arterij pa smo ocenjevali s provokacijskim testom na brahialni arteriji. Vsem preiskovancem smo odvzeli vzorce krvi za določitev viskoznosti plazme in spremenljivk, ki se kot dejavniki tveganja vključujejo v aterogenezo. V študijo smo vključili 28 bolnikov s povišanim krvnim tlakom, zdravljenih z inhibitorji angiotenzin-konvertaze, povprečne starosti 55,1 let. Skupino zdravih preiskovalcev je sestavljalo 22 prostovoljcev brez pomembnih dejavnikov tveganja za aterosklerozo, povprečne starosti 54,2 let. Skupina bolnikov je imela na vseh odsekih karotidne arterije značilno večjo povprečno debelino intime in medije kot zdravi preiskovanci (0,81 +- 0,7 proti 0,62 +- 0,07 mm, p < 0,0001) in številnejše aterosklerotične plake. Debelina intime in medije se je povečala s trajanjem povišanega krvnega tlaka, starostjo, večjim razmerjem pas-boki ter s koncentracijo glukoze in trigliceridov. (Izvleček prekinjen pri 2000 znakih.)
Descriptors		HYPERTENSION ATHEROSCLEROSIS CAROTID ARTERY, COMMON BRACHIAL ARTERY BLOOD VISCOSITY ADULT MIDDLE AGE AGED CASE-CONTROL STUDIES ULTRASONOGRAPHY, DOPPLER, DUPLEX ULTRASONOGRAPHY, DOPPLER, PULSED HEMORHEOLOGY AGE FACTORS VASODILATION ANGIOTENSIN-CONVERTING ENZYME INHIBITORS RISK FACTORS