Relação entre envelhecimento vascular, rigidez arterial e aterosclerose subclínica em pacientes hipertensos tratados

Abstract

Despite of various risk prediction algorithms already validated, these tools have been underused in primary care. Vascular age may be a more reasonable concept to the patient than the percentage of risk. The aim of this study was to compare chronological and vascular age in treated hypertensive patients concerning the association with subclinical arterial disease. Hypertensive patients (n=165), aged 30-75 years, without previous cardiovascular events were included in this study. After clinical evaluation, participants underwent radial applanation tonometry, measurement of pulse wave velocity (PWV) and carotid intima media thickness (IMT) by vascular ultrasound. Vascular age was calculated by the Framingham risk score for general cardiovascular disease. The subjects were initially separated by tertiles of chronological age and later by vascular age. Compared to chronological age, the highest tertile of vascular age presented greater values of aortic systolic pressure (150±18 vs 136±20 mmHg), carotid-femoral PWV (11.9±2.0 vs 11.1±2.0 m/s), mean and maximum carotid IMT (0.95±0.25 vs 0.86±0.13 and 1.10±0.38 vs 0.91±0.14 mm, respectively). These vascular parameters were progressively increasing in tertiles of vascular age but not with chronological age. The correlations of aortic systolic pressure (r=0.57, p<0.001), PWV (0.44, p<0.001), mean and maximum carotid IMT (r=0.66, p<0.001 and r=0.59, p<0.001, respectively) were greater with vascular than with chronological age. In conclusion, vascular age presented a better correlation with subclinical arterial disease, compared to chronological age, in treated hypertensive patients. These findings indicate that vascular age may be a useful tool to demonstrate the individual cardiovascular risk in this population.