Background Central (aortic) blood pressure (BP), which is the pressure exerted on the heart and brain, may be different from the pressure that is measured at the arm. Clinical studies have indicated that central BP may have predictive value independent of the corresponding peripheral (brachial) BP.
Objectives To study the central and peripheral BP in patients with ankylosing spondylitis (AS).
Methods 78 patients (6 female and 72 male, mean age ± SD 42,71±9.95 years) with reliable diagnosis of AS and without clinically-evident atherosclerosis were included. Diagnosis of AS were made according to the modified New York criteria. Duration of disease was 15.41±9.01 years. Control group consisted of 38 healthy age-matched volunteers. Central blood pressure (SBPao) was measured using TensioMed Arteriograph (TensioMed, Hungary).
Results We noted non-significantly increased central systolic BP in patients with AS compared controls group (123,2±23.09 vs. 115.66±13.73 mmHg; P=0.06). In healthy subjects differences between central and peripheral BP was -10.34±8.19 mm Hg, in patients with AS -7.24±6.96 mm Hg (p<0.05). In 17.9% patients with AS peripheral BP was higher than central BP (DBP >0), in all control subjects central BP was higher than peripheral (p<0.001). We study index CP =(SBPao/brachial systolic BP)×100. In patients with AS it was 94.2±5.19 mm Hg, in controls patient 91.81±6.39 mm Hg (p<0.05). Patients with AS and control group subjects was not differences by systolic BP, diastolic BP, pulse and mean BP. We noted correlations between SBPao and age (r=0,23 p<0,05), total cholesterol (r=0.37, p<0.01), left ventricular mass by echocardiography (r=0.39, p<0.01), carotid and brachial wall (r=0.69, p<0.01 and r=0.68, p<0.01). Also we noted correlations between SBPao and brachial augmentation index (Aix) (r=0,47, p<0,01), aortal Aix (r=0,56, p<0,001), pulse wave velocity (r=0,52, p<0,001). In control group this correlations we didn`t notified.
Conclusions The late systolic augmentation of the central pressure waveform is associated with an increase in left ventricular mass index independent of age and mean BP and carotid systolic BP is an independent determinant of left ventricular wall thickness. Moreover, central pressure is also more closely related to other important cardiovascular intermediate end points, such as vascular hypertrophy, extent of carotid atherosclerosis than brachial pressure.We noted significantly increased central BP and decreased dissociation between central and brachial BP in patients with AS compared with healthy persons.
Disclosure of Interest None Declared