title: Coronary microvascular function in patients with isolated systolic and combined systolic/diastolic hypertension.
abstract: Isolated systolic hypertension (ISH) is a common condition in the elderly that is associated with endothelial dysfunction. Concerning the effect of type of hypertension on coronary microvascular function, coronary flow reserve (CFR) in patients with ISH was evaluated and the results were compared with patients with combined systolic/diastolic hypertension (SDH). Seventy-six elderly patients (older than 60 years) who were free of coronary artery disease and diabetes mellitus were enrolled in the study (38 with ISH and 38 with combined SDH). Using transthoracic Doppler echocardiography, CFR was calculated as the ratio of hyperemic to baseline diastolic peak flow velocities. A CFR value of >2 was accepted as normal. The mean age was 68.6±6.3 years and the groups had similar features with regard to demographic and clinical characteristics. Patients with ISH had significantly lower CFR values compared with those with combined SDH (2.22±0.51 vs 2.49±0.56, respectively; P=.03). On multivariate regression analysis, ISH (β=-0.40, P=.004) and dyslipidemia (β=-0.29, P=.04) were the independent predictors of CFR. These findings indicate that CFR, an indicator of coronary microvascular/endothelial function, is impaired more profoundly in patients with ISH than in patients with combined SDH.
authors.affiliation: Department of Cardiology, Faculty of Medicine, Baskent University, Ankara, Turkey. hbozbas@gmail.com
authors.forename: Huseyin
authors.initials: H
authors.lastname: Bozbas
authors.forename: Bahar
authors.initials: B
authors.lastname: Pirat
authors.forename: Aylin
authors.initials: A
authors.lastname: Yildirir
authors.forename: Serpil
authors.initials: S
authors.lastname: Eroglu
authors.forename: Vahide
authors.initials: V
authors.lastname: Simsek
authors.forename: Elif
authors.initials: E
authors.lastname: Sade
authors.forename: Ilyas
authors.initials: I
authors.lastname: Atar
authors.forename: Alp
authors.initials: A
authors.lastname: Aydinalp
authors.forename: Bulent
authors.initials: B
authors.lastname: Ozin
authors.forename: Haldun
authors.initials: H
authors.lastname: Muderrisoglu
mesh_terms: D000368:Aged; D001783:Blood Flow Velocity; D001794:Blood Pressure / Q000502:physiology*; D003331:Coronary Vessels / Q000473:pathology / Q000503:physiopathology; D015150:Echocardiography, Doppler / Q000379:methods*; D004730:Endothelium, Vascular / Q000503:physiopathology; D005260:Female; D053805:Fractional Flow Reserve, Myocardial / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000503:physiopathology; D008297:Male; D008833:Microcirculation; D008875:Middle Aged; D011237:Predictive Value of Tests; D012044:Regression Analysis