Systemic hypertensionRelation of Impaired Coronary Microcirculation to Increased Urine Albumin Excretion in Patients With Systemic Hypertension and No Epicardial Coronary Arterial Narrowing
Section snippets
Methods
From the pool of patients who were referred or self-referred for evaluation of high blood pressure (BP) to the outpatient hypertension unit of our institute, we identified 37 consecutive never-treated essential hypertensives (57.9 years old, 16 men, Caucasian, daytime systolic BP >135 mm Hg) with positive ischemia treadmill exercise test results confirmed with thallium scintigraphy or dobutamine stress echocardiography who had no angiographically significant (<30%) stenoses in their coronary
Results
Hypertensive patients with low CFR compared to those with normal CFR did not differ in age, gender, body mass index, waist circumference, and metabolic profile (p = NS for all comparisons). Moreover, the difference in 24-hour systolic and diastolic BP values between study groups was not statistical significant (p = NS for the 2 comparisons). No change in CFR was detected in the 5 subjects who received the infusion of the normal saline solution.
Hypertensives with low CFR compared to those with
Discussion
The present study demonstrated an independent association of ACR with CFR assessed during cardiac catheterization in never-treated hypertensive patients asymptomatic for chest pain. According to our results hypertensives with impaired CFR and angiographically normal coronary arteries are characterized by increased ACR values, supporting the existence of a diffuse cardiorenal microcirculatory dysfunction.
Currently, no technique allows the direct in vivo visualization of coronary microcirculation
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