Nihat KALAY, Deniz ELÇİK, Şaban KELEŞOĞLU, Zeki ÇETİNKAYA, Sibel BOYLU, Rıdvan YURT, Ali DOĞAN, Mehmet Tuğrul İNANÇ, Mustafa DURAN

Effect of nondipper hypertension on coronary artery disease progression in patients with chronic coronary syndrome

Background/aim: It has been suggested that there is a significant progress in coronary artery disease (CAD) by many pathophysiological mechanisms. Nondipper hypertension (NDH) has been shown to have higher target organ damage and have a higher rate of cardiovascular mortality and morbidity. In this study, we investigated the effect of nondipper hypertension on the progression of coronary atherosclerosis. Materials and methods: A total of 186 patients who underwent coronary angiography twice between 6 months and 3 years were included in the study. Coronary angiography was repeated on the admission day due to angina or positive exercise test and the patients were divided into groups. Results: Progression of coronary artery disease was detected in 58 of 186 patients. Seventy-one of the total patients were found to be nondipper hypertensive. Nondipper hypertension, hypertension, diabetes mellitus, low-density lipoprotein, and total cholesterol were found to be effective in the progression of CAD. Among these parameters, it was seen that nondipper hypertension and hyperlipidemia were the most important independent risk factors. Conclusion: Coronary artery disease is a progressive disease, and this progression depends on many reasons. In our study, we showed that nondipper hypertension is a new parameter that is effective in CAD progression.Key words: Coronary artery disease, nondipper hypertension, progression

PDF

___

1. Goldberg IJ, Sharma G, Fisher EA. atherosclerosis: making a u turn. Annual Review of Medicine 2020; 27 (71): 191-201. doi: 10.1146/annurev-med-042418-011108
2. Costopoulos C, Maehara A, Huang Y, Brown AJ, Gillard JH et al. Heterogeneity of plaque structural stress is increased in plaques leading to mace: insights from the PROSPECT study. Journal of the American College of Cardiology Cardiovasc Imaging 2020; 13 (5): 1206-1218. doi: 10.1016/j.jcmg.2019.05.024
3. Millar-Craig MW, Bishop CN, Raftery EB. Circadian variation of blood-pressure. Lancet. 1978;1 (8068): 795-797. doi: 10.1016/s0140-6736(78)92998-7
4. Fujii T, Uzu T, Nishimura M, Takeji M, Kuroda S et al. Circadian rhythm of natriuresis is disturbed in nondipper type of essential hypertension. American Journal of Kidney Diseases 1999; 33 (1): 29-35. doi: 10.1016/s0272-6386(99)70254-4
5. Pierdomenico SD, Bucci A, Costantini F, Lapenna D, Cuccurullo F et al. Circadian blood pressure changes and myocardial ischemia in hypertensive patients with coronary artery disease. Journal of The American College of Cardiology 1998; 31: 1627-1634. doi: 10.1016/s0735-1097(98)00163-6
6. Ohkubo T, Hozawa A, Yamaguchi J, Kikuya M, Ohmori K et al. Prognostic significance of the nocturnal decline in blood pressure in individuals with and without high 24-h blood pressure: the Ohasama study. Journal of Hypertension 2002; 20 (11): 2183-2189. doi: 10.1097/00004872-200211000-00017
7. Berry C, L’Allier PL, Grégoire J, Lespérance J, Levesque S et al. Comparison of intravascular ultrasound and quantitative coronary angiography for the assessment of coronary artery disease progression. Circulation 2007; 10: 115(14): 1851-7. doi: 10.1161/CIRCULATIONAHA.106.655654
8. van Buuren F, Dahm JB, Horskotte D. Stent restenosis and thrombosis: etiology, treatment, and outcomes. Minerva Medicine 2012 ; 103(6): 503-11
9. Reiber JHC. Morphologic and densitometric quantitation of coronary stenoses; an overview of existing quantitation techniques. In: Reiber JHC, Serruys PW (editors) New Developments in Quantitative Coronary Arteriography. Developments in Cardiovascular Medicine, vol 87. Springer, Dordrecht. 1988. doi: 10.1007/978-94-009-1309-7_4
10. Lespérance J, Hudon G, White C, Laurier J, Waters D. Comparison by quantitative angiographic assessment of coronary stenoses of one view showing the severest narrowing to two orthogonal views. American Journal of Cardiology 1989; 64: 462-465. doi: 10.1016/0002-9149(89)90421-9
11. Kaski JC, Chester MR, Chen L, Katritsis D. Rapid angiographic progression of coronary artery disease in patients with angina pectoris. The role of complex stenosis morphology. Circulation 1995; 15: 92(8): 2058-2065. doi: 10.1161/01.cir.92.8.2058
12. Stary HC, Chandler AB, Glagov S, Guyton JR, Insull W Jr et al. A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. Circulation. 1994; 89 (5): 2462-2478. doi: 10.1161/01.cir.89.5.2462
13. Özdemir Hİ. The structural properties of carotid arteries in carotid artery diseases - a retrospective computed tomography angiography study. Polish Journal of Radiology. 2020; 10 (85):82-89. doi: 10.5114/pjr.2020.93367
14. Sahin O, Elcik D, Dogan A, Cetinkaya Z, Cetin A et al. The relation of serum trace elements and coronary atherosclerotic progression. Trace Elements and Electrolytes 2019; 36: 210- 214. doi: 10.5414/TEX01570
15. Nagai M, Hoshide S, Ishikawa J, Shimada K, Kario K. Visit-to-visit blood pressure variations: new independent determinants for carotid artery measures in the elderly at high risk of cardiovascular disease. Journal of the American Society of Hypertension 2011; 5 (3): 184-192. doi: 10.1016/j. jash.2011.03.001
16. Shimbo D, Shea S, McClelland RL, Viera AJ, Mann D, Newman J et al. Associations of aortic distensibility and arterial elasticity with long-term visit-to-visit blood pressure variability: the Multi-Ethnic Study of Atherosclerosis (MESA). American Journal of Hypertension 2013; 26 (7): 896-902. doi: 10.1093/ ajh/hpt040
17. Lehmann N, Erbel R, Mahabadi AA, Kälsch H, Möhlenkamp S et al. Accelerated progression of coronary artery calcification in hypertension but also prehypertension. Journal of Hypertension. 2016; 34(11): 2233-2242. doi: 10.1097/ HJH.0000000000001080
18. Gronewold J, Kropp R, Lehmann N, Stang A, Mahabadi AA et al. Cardiovascular risk and atherosclerosis progression in hypertensive persons treated to blood pressure targets. Hypertension 2019; 74(6): 1436-1447. doi: 10.1161/ HYPERTENSIONAHA.119.13827
19. Lerman A. The endothelium. 2nd ed. In: Murphy JG (editor). Mayo Clinic Cardiology Review, Philadelphia, USA: Lippincott Williams & Wilkins, 2001
20. Landmesser U, Drexler H. The clinical significance of endothelial dysfunction. Current Opinion in Cardiology. 2005; 20(6): 547-551. doi: 10.1097/01.hco.0000179821.11071.79
21. Tsutsui M, Shimokawa H, Otsuji Y, Ueta Y, Sasaguri Y, Yanagihara N. Nitric oxide synthases and cardiovascular diseases: insights from genetically modified mice. Circulation Journal 2009; 73(6): 986-993. doi: 10.1253/circj.cj-09-0208
22. Atasoyu ME, Ünver S, Cingözbay Y, Evrenkaya TR, Tülbek MY. Genç normotansif ve hipertansif bireylerde ayaktan kan basıncı izlemi sonuçları. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi 2001; 10: 115-122 (in Turkish).
23. Higashi Y, Nakagawa K, Kimura M, Noma K, Hara K et al. Circadian variation of blood pressure and endothelial function in patients with essential hypertension: a comparison of dippers and nondippers. Journal of the American College of Cardiology 2002; 40: 2039-2043. doi: 10.1016/s0735- 1097(02)02535-4
24. Smith SC Jr, Faxon D, Cascio W, Schaff H, Gardner T et al. Prevention Conference VI: Diabetes and Cardiovascular Disease: Writing Group VI: revascularization in diabetic patients. Circulation 2002; 105(18): 165-169. doi: 10.1161/01. cir.0000013957.30622.05
25. Wild S, Roglic G, Green A, Sicree R, King H. Global prevalence of diabetes: estimates for the year 2000 and projections for 2030. Diabetes Care. 2004; 27(5): 1047-1053. doi: 10.2337/ diacare.27.5.1047
26. Klein L, Gheorghiade M. Management of the patient with diabetes mellitus and myocardial infarction: clinical trials update. The American Journal of Medicine 2004; 8 (116 Suppl 5A): 47-63. doi: 10.1016/j.amjmed.2003.10.020