Fluid shear stress on the endothelium of the carotid artery wall and coronary artery calcinosis in patients with arterial hypertension

Objective: to study the interconditionality of changes in the fluid shear stress on the endothelium (FSE) of the common carotid artery (CCA) wall which is intact from atherosclerosis with the value of the Cardiac Calcium Score (CCS) among patients with e arterial hypertension (AH).

Materials and methods: the study included 99 patients with AH, 52 of them had atherosclerotic lesions of the brachiocephalic arteries (BCA). The ultrasound investigation of the carotid arteries with the determination of FSE in the intact area of the CCA, multispiral computed tomography of the coronary arteries with the determination of CCS were performed to all patients.

Results: the prevalence of BCA atherosclerotic lesion in the study was 53%. The mean value of FSE for patients with AH and BCA atherosclerosis (group 1) were 660.7 (185.6) c-1, for patients with AH without its (group 2) — 735.8 (149.8) c-1, p = 0.009. The parameters of the lipid spectrum in patients of both groups were comparable. Мedian value of CCS in patients with atherosclerotic lesions of the BCA were statistically significantly higher (15.00 (0.00; 178.00),) compared with patients of the group 2 (0.00 (0.00; 171.00), at p = 0.001. The chances of detecting coronary artery calcification among patients of group 1 are in 2 times higher (OR = 2.25, 95% CI: 1.58-8.33) than among patients of group 2. Low FSE values correlated with male gender (rs = 0.40 (95% CI: 0.22; 0.55) p <0.001) and increasing of CCS (rs = -0.23 (95% CI: -0.41; -0.04) p = 0.022).

Conclusions: the prevalence of atherosclerotic lesions of the BCA among patients with AH without a history of symptomatic diseases associated with atherosclerosis was 53%. In the group of patients with AH and atherosclerotic lesions of the BCA, median values of CCS were significantly higher, and coronary artery lesions were detected significantly more often (OR = 2.25, 95% CI: 1.58-8.33) than among patients with AH and intact BCA. The mean value of FSE for patients with AH and BCA atherosclerosis were statistically significantly lower than for patients with AH without it and amounted to 660.7 (185.6) c-1 and 735.8 (149.8) c-1, respectively, p = 0.009. Low FSE values correlated with male gender and increasing of CCS 

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