Impact of blood pressure control on coronary flow reserve in hypertensive patients
10.3760/cma.j.issn.0253-3758.2016.05.011
- VernacularTitle:血压控制水平对高血压患者冠状动脉血流储备的影响
- Author:
Lanfang DU
1
;
Zhaoping LI
;
Dan LI
;
Weihong LI
;
Chuan REN
;
Qingbian MA
;
Wei GAO
Author Information
1. 100191,北京大学第三医院心内科卫生部心血管分子生物学与调节肽重点实验室分子心血管学教育部重点实验室
- Keywords:
Hypertension;
Fractional flow reserve,myocardial;
Echocardiography
- From:
Chinese Journal of Cardiology
2016;44(5):421-425
- CountryChina
- Language:Chinese
-
Abstract:
Objective To investigate the impacts of blood pressure control on coronary flow reserve (CFR) in hypertensive patients.Methods A total of 236 patients without significant coronary stenosis (defined as ＜ 50％ luminal narrowing which was confirmed by coronary angiography or coronary artery CT scan) between January 201 1 to July 2015 were retrospectively enrolled in this study.CFR was measured in the left anterior descending coronary artery (LAD) during adenosine triphosphate-induced hyperemia by transthoracic Doppler echocardiography.Patients were divided into hypertension group (n =173) and nonhypertension group (n =63).The hypertension patients were further divided into ideally controlled (a =31,defined as SBP ＜ 120 mmHg (1 mmHg =0.133 kPa) and DBP ＜80 mmHg),controlled (n =82,defined as SBP 120 to 139 mmHg and DBP ＜ 90 mmHg) and uncontrolled groups (n =60,defined as SBP ≥ 140 mmHg and/or diastolic DBP ≥ 90 mmHg) based on their blood pressure after systematic antihypertensive therapy and CFR values were compared among the 4 groups.Multivariate regression analyses were performed to identify the independent determinants of CFR in patients with hypertension.Results Compared with nonhypertension group,the CFR was significantly lower in controlled (3.27 ± 0.71 vs.2.87 ± 0.56,P ＜ 0.001) and uncontrolled groups (3.27 ± 0.71 vs.2.61 ± 0.71,P ＜ 0.001),but was similar in ideally controlled group (3.27 ±0.71 vs.3.21 ±0.85,P =0.68).Furthermore,the CFR was significantly lower in uncontrolled group than that of the other two hypertension groups and was significantly lower in controlled group than that of ideally controlled group.Higher blood pressure ([β =-0.17,P =0.03) and age (β =-0.02,P =0.03) were independent predictors of lower CFR in patients with hypertension.Conclusions Higher blood pressure is an independent predictor of decreased CFR in patients with hypertension.Hypertensive patients with ideally controlled blood pressure have similar CFR level as patients without hypertension.
