Heterogeneity of the atherosclerotic process in systemic hypertension poorly controlled by drug treatment

A cross-sectional study of 85 patients with poorly controlled treated hypertension was performed to detect, by means of aortic pulse wave velocity measurement and ultrasonic examinations, subclinical alterations of arteries. Pulse wave velocity was related to the product of age and diastolic blood pressure (BP) according to a nomogram obtained from normotensive subjects, and was found inside the nomogram in 37 patients (group 1) and outside in 48 (group II). Group II had higher systolic and pulse BP (p <0.01), lower diastolic BP (p <0.01), higher proportion of cigarette smokers (p <0.05) and higher blood glucose levels (p <0.02) than group I. In group 11 a positive correlation existed between blood glucose and pulse wave velocity (p <0.01). Group 11 had a higher frequency of carotid artery stenosis (p <0.05) and a trend toward increased frequency of aortic and lower limb atherosclerotic lesions. The results indicate a heterogeneous pattern of arterial alterations in which systolic BP, cigarette smoking and blood glucose level are implicated.