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Second Congress of Cardiology and Angiology of Bosnia & Herzegovina

 

ARTERIAL HYPERTENSION AND MULTIFOCAL ATHEROSCLEROTIC DISEASE
A. Mlaćo, M. Dilić, S. Pehar, O. Terzić, S. Kazić and A. Kurčehajić
Institute of Vascular Diseases, Clinical Center University of Sarajevo, Bosnia and Herzegovina

Background: it is well known that atherosclerosis as systemic disease have a significant correlation with score of multiple risk factors (MRF) and intima-media thickness (IMT) of magistral arteries, i.e. common carotid, brachial, and common femoral. Atherosclerosis as a multifocal disease, produces multisegmental stenotic changes of various arterial segments which arises simultaneously as a pre-existing asymptomatic disease. Aim of this study is to evaluate presence of multifocal atherosclerotic disease among pts. with predominant arterial occlusive disease (AOD), and to correlate arterial hypertension as a major independent risk factor and multifocal atherosclerotic disease. Methods: we included 109 consecutive patients treated at our Institute in the period Dec 1999 - Dec 2000, all with clear arterial occlusive disease (AOD). According to Fontaine clinical staging of their AOD we made three groups - group A, clinical stage II 63 pts, group B, clinical stage III 32 pts, and group C, clinical stage IV 14 pts. We evaluated clnical variables: age, gender, arterial hypertension (HTA), tobacco, hyperlipidemia (HLP), obesity (BMI), diabetes mellitus, coronary heart disease (CHD), and cerebrovascular disease (CVD). Score of MRF is calculated as x/9. Special focus has made to pts. with positive HTA. All pts. were evaluated according to clinical evidence of CHD and CVD, respectively. Results: we had 109 pts, 89 males and 20 females, average age of 62 yrs, males 63 and females 60 yrs. In the A group were 63 pts. with average MRF 4,27, in the B group 32 pts.with MRF 3,97, in the C group 14 pts.with MRF 3,93. Out of total number of pts. 52 were hypertensive (47,7%), 41 males, and 11 females, with average age 64,8 yrs, males, and 61,8 yrs, females. Isolated systolic HTA had 33 pts. (63,5%), and 19 pts.(36,5%) sysotlic and dyastolic HTA. In whole group (n-109), multifocal disease, AOD+CHD, had 30 pts. (MRF score 4,2), AOD+CVD had 14 pts. (MRF score 4,1). In hypertensive pts. multifocal atherosclerotic disease, AOD+CHD, had 15 pts. (29%), while AOD+CVD had 3 pts. (6%), and AOD+CHD+CVD, 2 pts (4%). Among clinical variables, tobacco was of high risk, 97 pts. positive (89,9%), what is of high significance, p<0,0001. Conclusions: we have a clear connection in our group of AOD pts. with elevated MRF score, especially clinical variables, arterial hypertension (p<0,01), and smoking (p<0,0001). Multifocal atherosclerotic disease was present in 44 pts.(40,4%), and among hypertensive pts. multifocal atherosclerotic disease was present in 15 pts.(28,9%). There is a positive correlation rank of multifocal disease and all clinical vaiables, r=.64, and borderline correlation rank of multifocal disease and HTA, r=.37.

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