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Karotis arter hasarını etkileyen kan basıncı sınırları: kesitsel bir çalışma

Yıl 2020, Cilt: 45 Sayı: 3, 971 - 976, 30.09.2020
https://doi.org/10.17826/cumj.702344

Öz

Amaç: Yüksek kan basıncının karotis arterler üzerinde istenmeyen etkilere yol açtığı iyi bilinmesine ragmen bu etkinin hangi değerden itibaren başladığı net değildir. Bu çalışmanın amacı bunu değerlendirmektir.
Yöntem: Çalışma kesitsel planlandı ve toplam 308 birey dahil edildi. Sistolik kan basıncı (SKB) <120 mmHg ve diyastolik kan basıncı (DKB) <90 mmHg olan (optimal) bireyler 1.Gruba, SKB 120-129 mmHg ve/veya DKB 80-84 mmHg olan (normal) bireyler 2.Gruba, SKB 130-139 mmHg ve/veya DKB 85-89 mmHg olan (yüksek-normal) bireyler 3.Gruba, SKB 140-159 mmHg ve/veya DKB 90-99 mmHg olan bireyler 4.Gruba, SKB 160-179 mmHg ve/veya DKB 100-109 mmHg olan bireyler 5.Gruba ve SKB≥180 mmHg ve/veya DKB≥110 mmHg olan bireyler 6.Gruba alındı. Tüm gruplarda karotis distensibilitesi ve elastisitesi ölçülerek gruplar arasında fark olup olmadığı ve eğer fark var ise hangi kan basıncı değerinden itibaren bu farkın oluşmaya başladığı değerlendirildi.
Bulgular: Tüm gruplar arasında karotis distensibilitesi ve elastisitesi yönünden istatistiksel anlamlı fark vardı (p<0.001, her iki değer için). Grup 2 ve 1 arasında anlamlı fark saptanmadı (p>0.05) ancak grup 3 ile 1 arasında anlamlı fark vardı (p<0.05). SKB>135,5 mmHg olmasının%78,2 sensitivite, %74,6 spesifite, DKB>86,5 mmHg olmasının %79,3 sensitivite ve %71,6 spesifite ile karotis distensibilitesini etkilemeye başladığı bulundu. Benzer olarak SKB>137,5 mmHg olmasının %80,4 sensitivite, %73,1 spesifite, DKB>88,5 mmHg olmasının ise %79,1 sensitivite ve %73,8spesifite ile karotis elastisitesini etkilemeye başladığı gösterildi.
Sonuç: Karotis distensibilitesi ve elastisitesi kan basıncının artışı ile azalmaktadır. Yüksek-normal kan basıncına sahip bireylerde belirli bir kan basıncı değerinden sonra karotis hasarı başlıyor olabilir.

Proje Numarası

KA19/339

Kaynakça

  • 1. Benjamin EJ, Muntner P, Alonso A et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139:e56-e528.
  • 2. Vernon ST, Coffey S, Bhindi R, et al. Increasing proportion of ST elevation myocardial infarction patients with coronary atherosclerosis poorly explained by standard modifiable risk factors. Eur J Prev Cardiol2017;24:1824–1830.
  • 3. Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million. people. Lancet 2014; 383: 1899–1911.
  • 4. Williams B, Mancia G, Spiering W, et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39: 3021-3104.
  • 5. Liao D, Arnett DK, Tyroler HA, et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999;34:201–206.
  • 6. Jaroch J, Łoboz-Grudzień K, Magda S, et al.The Relationship of Carotid Arterial Stiffness and Left Ventricular Concentric Hypertrophy in Hypertension. Adv Clin Exp Med. 2016;25:263-272.
  • 7. Tzortzis S, Ikonomidis I, Lekakis J, et al.Incremental predictive value of carotid intima-media thickness to arterial stiffness for impaired coronary flow reserve in untreated hypertensives. Hypertens Res. 2010;33:367-373.
  • 8. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr2008;21:93–111.
  • 9. Touboul PJ, Hennerici MG, Meairs S, et al. Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012;34:290–296.
  • 10. Marlatt KL, Kelly AS, Steinberger J, et al. The influence of gender on carotid artery compliance and distensibility in children and adults. J Clin Ultrasound 2013;41:340–346.
  • 11. Koivistoinen T, Virtanen M, Hutri-Kähönen N, et al. Arterial pulse wave velocity in relation to carotid intima-media thickness, brachial flow-mediated dilation and carotid artery distensibility: the Cardiovascular Risk in Young Finns Study and the Health 2000 Survey. Atherosclerosis 2012;220:387–393.
  • 12. Juonala M, Järvisalo MJ, Mäki-Torkko N, et al. Risk factors
identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation 2005;112:1486–1493.
  • 13. Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917): 868–874.
  • 14. Hurtubise J, McLellan K, Durr K, Onasanya O, Nwabuko D, Ndisang JF. The Different Facets of Dyslipidemia and Hypertension in Atherosclerosis. CurrAtheroscler Rep. 2016;18:82.
  • 15. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572.
  • 16. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–520.
  • 17. Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens. 2019;33:34-40.
  • 18. Paul TK, Chen W, Srinivasan SR, He J, Berenson GS. Contrast of the impact of multiple cardiovascular risk factors on the femoral and carotid intima-media thickness in asymptomatic young adults: the Bogalusa Heart Study. Atherosclerosis 2011;216:359–364.
  • 19. Natali A, Muscelli E, Casolaro A, et al. Metaboliccharacteristics of prehypertension: role of classi- ficationcriteriaandgender. J Hypertens. 2009;27:2394–2402.
  • 20. Boesen ME, Singh D, Menon BK, Frayne R. A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity. Atherosclerosis. 2015;243:211-222.

Blood pressure limits affecting carotid artery injury: a cross sectional study

Yıl 2020, Cilt: 45 Sayı: 3, 971 - 976, 30.09.2020
https://doi.org/10.17826/cumj.702344

Öz

Objective: Although it is well known that high blood pressure causes undesirable effects on carotid arteries, it is not clear as to which threshold value this effect starts. The aim of this study is to evaluate and determine this threshold.
Materials and Methods: This cross-sectional study included a total of 308 individuals in the following groups; Group 1: individuals with systolic blood pressure (SBP) <120 mmHg and diastolic blood pressure (DBP) <80 mmHg (optimal), Group 2: SBP 120-129 mmHg and/or DBP 80-84 mmHg (normal), Group 3: SBP 130-139 mmHg and/or DBP 85-89 mmHg (high-normal), Group 4: SBP 140-159 mmHg and/or DBP 90-99 mmHg, Group 5: SBP 160-179 mmHg and/or DBP 100-109 mmHg, and Group 6: SBP≥180 mmHg and/or DBP≥110 mmHg. Carotid distensibility and elasticity were measured in all groups.
Results: A statistically significant difference was determined between the groups in carotid distensibility and elasticity (p<0.001, for both values). There was no significant difference between groups 2 and 1 (p>0.05), but there was a significant difference between other groups (groups 3-4-5) and group 1 (p<0.05, for all comparisons). SBP>135.5 mmHg started to affect carotid distensibility with 78.2% sensitivity and 74.6% specificity, and DBP>86.5 mmHg with 79.3% sensitivity and 71.6% specificity. Carotid elasticity was seen to be affected by SBP>137.5 mmHg with 80.4% sensitivity and 73.1% specificity, and DBP>88.5 mmHg with 79.1% sensitivity and 73.8% specificity.
Conclusion: Carotid distensibility and elasticity decreases with increasing blood pressure. In individuals with high-normal blood pressure, carotid damage may begin after a certain blood pressure value.

Destekleyen Kurum

Başkent Üniversitesi

Proje Numarası

KA19/339

Teşekkür

Dear Editor; Please find our report entitled “Blood Pressure Limits Affecting Carotid Artery Injury. A Cross Sectional Study”. We hope you will find our report interesting for reviewing and publishing it in your esteemed Journal. This report had not been published before or is not under review elsewhere. None of the paper’s contents have previously published. All authors have read and approved the manuscript. On behalf of all the contributors I will act and guarantor and will correspond with the journal from this point onward. All authors declare that they have no conflicts of interest. The authors have indicated they have no financial relationships relevant to this article to disclose. This study was approved by Baskent University Institutional Review Board and Ethics Committee and supported by Baskent University Research Funding (KA19/339). Yours sincerely, Aylin Güneşli MD, Baskent University, Department of Radiology, Yuregir, Adana, Turkey 03-11-2020

Kaynakça

  • 1. Benjamin EJ, Muntner P, Alonso A et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics-2019 Update: A Report From the American Heart Association. Circulation. 2019;139:e56-e528.
  • 2. Vernon ST, Coffey S, Bhindi R, et al. Increasing proportion of ST elevation myocardial infarction patients with coronary atherosclerosis poorly explained by standard modifiable risk factors. Eur J Prev Cardiol2017;24:1824–1830.
  • 3. Rapsomaniki E, Timmis A, George J, et al. Blood pressure and incidence of twelve cardiovascular diseases: lifetime risks, healthy life-years lost, and age-specific associations in 1.25 million. people. Lancet 2014; 383: 1899–1911.
  • 4. Williams B, Mancia G, Spiering W, et al; ESC Scientific Document Group. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J. 2018; 39: 3021-3104.
  • 5. Liao D, Arnett DK, Tyroler HA, et al. Arterial stiffness and the development of hypertension. The ARIC study. Hypertension 1999;34:201–206.
  • 6. Jaroch J, Łoboz-Grudzień K, Magda S, et al.The Relationship of Carotid Arterial Stiffness and Left Ventricular Concentric Hypertrophy in Hypertension. Adv Clin Exp Med. 2016;25:263-272.
  • 7. Tzortzis S, Ikonomidis I, Lekakis J, et al.Incremental predictive value of carotid intima-media thickness to arterial stiffness for impaired coronary flow reserve in untreated hypertensives. Hypertens Res. 2010;33:367-373.
  • 8. Stein JH, Korcarz CE, Hurst RT, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: a consensus statement from the American Society of Echocardiography Carotid Intima-Media Thickness Task Force. Endorsed by the Society for Vascular Medicine. J Am Soc Echocardiogr2008;21:93–111.
  • 9. Touboul PJ, Hennerici MG, Meairs S, et al. Mannheim carotid intima-media thickness and plaque consensus (2004-2006-2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis 2012;34:290–296.
  • 10. Marlatt KL, Kelly AS, Steinberger J, et al. The influence of gender on carotid artery compliance and distensibility in children and adults. J Clin Ultrasound 2013;41:340–346.
  • 11. Koivistoinen T, Virtanen M, Hutri-Kähönen N, et al. Arterial pulse wave velocity in relation to carotid intima-media thickness, brachial flow-mediated dilation and carotid artery distensibility: the Cardiovascular Risk in Young Finns Study and the Health 2000 Survey. Atherosclerosis 2012;220:387–393.
  • 12. Juonala M, Järvisalo MJ, Mäki-Torkko N, et al. Risk factors
identified in childhood and decreased carotid artery elasticity in adulthood: the Cardiovascular Risk in Young Finns Study. Circulation 2005;112:1486–1493.
  • 13. Libby P. Inflammation in atherosclerosis. Nature. 2002;420(6917): 868–874.
  • 14. Hurtubise J, McLellan K, Durr K, Onasanya O, Nwabuko D, Ndisang JF. The Different Facets of Dyslipidemia and Hypertension in Atherosclerosis. CurrAtheroscler Rep. 2016;18:82.
  • 15. Chobanian AV, Bakris GL, Black HR, et al. The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report. JAMA. 2003;289:2560–2572.
  • 16. James PA, Oparil S, Carter BL, et al. 2014 evidence-based guideline for the management of high blood pressure in adults: report from the panel members appointed to the Eighth Joint National Committee (JNC 8). JAMA. 2014;311:507–520.
  • 17. Cuspidi C, Sala C, Tadic M, Gherbesi E, Grassi G, Mancia G. Pre-hypertension and subclinical carotid damage: a meta-analysis. J Hum Hypertens. 2019;33:34-40.
  • 18. Paul TK, Chen W, Srinivasan SR, He J, Berenson GS. Contrast of the impact of multiple cardiovascular risk factors on the femoral and carotid intima-media thickness in asymptomatic young adults: the Bogalusa Heart Study. Atherosclerosis 2011;216:359–364.
  • 19. Natali A, Muscelli E, Casolaro A, et al. Metaboliccharacteristics of prehypertension: role of classi- ficationcriteriaandgender. J Hypertens. 2009;27:2394–2402.
  • 20. Boesen ME, Singh D, Menon BK, Frayne R. A systematic literature review of the effect of carotid atherosclerosis on local vessel stiffness and elasticity. Atherosclerosis. 2015;243:211-222.
Toplam 20 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Radyoloji ve Organ Görüntüleme
Bölüm Araştırma
Yazarlar

Aylin Güneşli 0000-0002-8337-6905

Aynur Acıbuca 0000-0002-3444-8845

Cihan Altın 0000-0002-3996-5681

Esin Gezmiş Bu kişi benim 0000-0002-1001-6028

Mustafa Agah Tekindal 0000-0002-4060-7048

Çiğdem Yalçın Bu kişi benim 0000-0001-5483-8253

Ozlem Alkan 0000-0001-7526-3460

Proje Numarası KA19/339
Yayımlanma Tarihi 30 Eylül 2020
Kabul Tarihi 28 Mayıs 2020
Yayımlandığı Sayı Yıl 2020 Cilt: 45 Sayı: 3

Kaynak Göster

MLA Güneşli, Aylin vd. “Blood Pressure Limits Affecting Carotid Artery Injury: A Cross Sectional Study”. Cukurova Medical Journal, c. 45, sy. 3, 2020, ss. 971-6, doi:10.17826/cumj.702344.