2014


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2014/№1

Models of the interrelation between cardiovascular risk, oxidative stress and vascular wall condition: Results of a cross-sectional study on patients with AH and IHD

Ageev F. T., Plisyuk A. G., Ovchinnikov A. G., Kuzmina A. E., Kulev B. D., Vitsenya M. V., Zhubrina E. S.
Federal State Budgetary Institution, "Russian Cardiology Science and Production Center" of the RF Ministry of Health Care, 3rd Cherepkovskaya 15a, Moscow 121552

Keywords: oxidative stress, flow-dependent vasodilation, cardiovascular risk, pulse wave velocity

DOI: 10.18087/rhj.2014.1.1878

Background. The search for and identification of actually “working” risk factors (RFs) are impossible without understanding general mechanisms of disease development and interactions of its individual steps. Aim. 1) To evaluate the connection between oxidative stress and various risk factors (RF) and influence of both of them on arterial wall in patients with AH and IHD. 2) To find out the model of coupling risk factors, oxidative balance and arterial wall features. Materials and methods. This cross-sectional study was performed on 170 AH patients (mean age, 58 years; females, 55 %; patients with AH+IHD combination, 23%) with different degrees of the risk for cardiovascular complications (CVC). The CVC risk was evaluated by SCORE for AH patients and by SMART for IHD patients. OB was calculated from the oxidative resistance index (ORI) as the ratio of antioxidant enzyme (superoxide dismutase, SOD) activity to plasma level of malonic dialdehyde (MDA): ORI=SOD / MDA.Functional status of vascular endothelium was determined using the reactive hyperemia test (flow-dependent vasodilation, FDVD); arterial elasticity was assessed by the pulse wave velocity (PWV). Results. The monofactorial analysis found correlations of SCORE with ORI (r=–0.45; p<0.01), ORI with FDVD (r=0.45; p<0.01), and FDVD with PWV (r=–0.32; p<0.05) in AH patients. In the multifactorial analysis, the SCORE risk proved to be an independent predictor of ORI whereas ORI was a single predictor of FDVD. In IHD patients, SMART correlated with ORI (r=–0.44; p<0.05) and ORI correlated with FDVD (r=0.31; p<0.05). As distinct from AH, no correlation between FDVD and PWV was found. In the multifactorial analysis, the SMART risk was found to be an independent predictor of ORI and ORI was a predictor of FDVD. Age and systolic BP (SBP) were traditionally independent predictors of PWV in AH and only SBP – in IHD. Conclusion. Combined effects of RFs result in impairment of OB, which leads to reduced FDVD both in AH and IHD. The decrease in FDVD, in its turn, results in increased arterial wall stiffness (increased PWV) in AH patients. In IHD patients, the increase in PWV is determined by other mechanisms, primarily by the level of SBP.
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Ageev F. T., Plisyuk A. G., Ovchinnikov A. G. et al. Models of the interrelation between cardiovascular risk, oxidative stress and vascular wall condition: Results of a cross-sectional study on patients with AH and IHD. Russian Heart Journal. 2014;75 (1):59–64

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