EVALUATION OF CAROTID - FEMORAL ARTERIAL PULSE VELOCITY AND ITS RELATIONSHIP TO NATRIURETIC PEPTIDES LEVELS IN HYPERTENSIVE PATIENTS WITH METABOLIC SYNDROME OR TYPE 2 DIABETES MELLITUS

Background: There is higher incidence of asymptomatic left ventricular dysfunction in hypertensive patients with type 2 diabetes mellitus  (HT + DM) or patients with metabolic syndrome (MS).  Using plasma natriuretic peptide  levels (BNP, NT-proBNP) in diagnosing of this state and its relation to arterial system´s damage is still a subject for controversial discussions.
Methods: We evaluated the plasma BNP and NT-proBNP levels in 48 patients with metabolic syndrome (MS) – average age: 45,5 ± 11,3 years, body mass index (BMI): 32,1, blood pressure (BP) 141±15/93±8 mmHg  and group HT + DM  of 48 patients  – average age: 63,8 ± 10,6 years, BMI : 29,6 ± 4,61, BP 152±10/96±8 mmHg. Both groups of patients were of intact renal function. The properties of peripheral arteries were evaluated by measurement of pulse wave velocity (PWV)  between aorta and femoral artery.
Results: All patients had normal left ventricular systolic function, patients with DM+HT had higher left ventricular mass index compared to patients with MS ( 107,3 to 93,05 g/m2). The plasma levels of BNP and NT-proBNP were increased in patients with HT+DM more than in the group with MS ( 44,2 to 15,0 pmol/l in BNP, 34,58 to 7,873 pmol/l in NT-proBNP, p=0.005). Average values of PWV were in the group with MS lower than in the group with HT+DM (11,33m/s to 13,09 m/s, p=0.005).
Conclusions: The correlation between the properties of peripheral arteries, characterized by PWV, and plasma levels of BNP and NT-proBNP on the other side was found.
Arterial stiffness in hypertensive patients revealed some relation to the  LV dysfunction. The measurement of the PWV may contribute to the prediction of LV dysfunction  in hypertensive  patients with MS or DM. Both groups of patients will be further followed up.