Central aortic pressure, precerebral artery status, and renal function in individuals at high cardiovascular risk

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Cardiovascular diseases (CVDs) are among the leading causes of death in the Kyrgyz Republic. The prevalence of CVD risk factors (RF) is subject to significant geographical variations and the influence of gender and socio-economic factors.

OBJECTIVE

To study central aortic pressure, the structural status of carotid and vertebral arteries, and their correlation with renal function in individuals at high cardiovascular risk based on gender.

MATERIALS AND METHODS

A total of 258 patients at high cardiovascular risk (CVR) were included in the study. The mean age was 52.5±12.3 years (18 to 76 years). In addition to general clinical examination, the central aortic pressure (CAP), the state of the precerebral arteries, and renal function were assessed in all patients. In females (n=133) and males (n=125), the prevalence of the most significant CVD RFs was estimated: tachycardia, hypertension (AH), obesity, hypercholesterolemia (HCH), hypertriglyceridemia (HTG), dyslipidemia (DLP), anemia, elevated C-reactive protein (CRP), proteinuria.

RESULTS

In females with high CVR, mean age, CAP, lipid spectrum parameters, and blood glucose were slightly higher. A significant increase in body mass index (29.3±6.0 kg/m² and 27.9±5.7 kg/m², p<0.05), a significant decrease in hemoglobin (129.07±20.14 g/L and 148.31±29.72 g/L, p<0.05), the erythrocyte count (4.45±0.61×10¹²/L and 4.98±0.88×10¹²/L, p<0.05), and a decrease in the diameter of the left vertebral artery (0.34±0.05 cm and 0.37±0.05 cm, p<0.05) were noted in females. In males, the thickness of the intima-media complex of the right and left carotid arteries, the diameter of the aortic outflow tract, serum cystatin C levels [1.18 (1.01; 1.65) mg/L and 1.09 (0.93; 1.46) mg/L, p<0.05)] and creatinine [86.0 (71.8; 114.0) µmol/L and 67.1 (57.3; 89.0) µmol/L, p<0.05)] were significantly higher, and the glomerular filtration rate (GFR) for cystatin C (48.11±6.15 mL/min and 51.02.51±9.19 mL/min, p<0.05) and creatinine (61.03±11.07 mL/min and 67.51±26.57 mL/min, p<0.05) was significantly lower. In females and males, the prevalence of CVD RFs was as follows: overweight (35.8% and 40.0%), obesity (43.6% and 27.2%, p<0.05), tachycardia (37.5% and 48.0%), hypertension (42.8% and 56.0%, p<0.05), anemia (19.5% and 13.6%), renal failure (29.3% and 31.2%), HCH (46.6% and 34.4%, p<0.05), DLP (58.6% and 45.6%, p<0.05), HTG (36.0% and 31.2%), elevated CRP (18.0% and 16.8%), proteinuria (13.5% and 35.2%, p<0.05). The correlation analysis showed a significant relationship between the diameter of the aortic outflow tract and serum cystatin C (r=0.209, p<0.05); the estimated GFR with the diameter of the right vertebral artery (r= –0.152, p<0.05); the values of CAP, serum cystatin C (r=0.295, p<0.05) and GFR (r= –0.293, p<0.05).

CONCLUSIONS

In women at high cardiovascular risk, common risk factors for cardiovascular disease were obesity, anemia, and atherogenic blood lipid spectrum. In men at high cardiovascular risk, structural alteration of the precerebral arteries was associated with decreased renal filtration, hypertension, and proteinuria. Women and men at high cardiovascular risk have a significant association between increased central aortic pressure and precerebral artery remodeling and renal function.

Keywords:

central aortic pressure

carotid arteries

vertebral arteries

renal function

cardiovascular risk

medical and social aspects

health care

Authors:

Murkamilov I.T.

I.K. Akhunbaev Kyrgyz State Medical Academy;
Kyrgyz-Russian Slavic University named after the First President of Russian Federation B.N. Yeltsin

ORCID: 0000-0001-8513-9279

Fomin V.V.

Sechenov University

ORCID: 0000-0002-2682-4417

Sabirov I.S.

Kyrgyz-Russian Slavic University named after the First President of Russian Federation B.N. Yeltsin

ORCID: 0000-0002-8387-5800

Yusupov F.A.

Osh State University

ORCID: 0000-0003-0632-6653

Aidarov Z.A.

I.K. Akhunbaev Kyrgyz State Medical Academy

ORCID: 0000-0003-2323-5702

Received:

05.02.2023

Accepted:

10.03.2023

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