Peripheral vessel wall changes in hypertensive patients with gout

Aim. To investigate the specific features of arterial wall endothelial dysfunction and stiffness in patients with hypertension concurrent with gout. Subjects and methods. A total of 54 patients were examined and divided into 2 groups. A study group consisted of 33 hypertensive patients with gout and a comparison group included 21 hypertensive patients without hyperuricemia. The patients did not differ in blood pressure (BP) readings. Uric acid was determined by the reaction with tungstophosphoric solution AT (Reagent, Dnepropetrovsk, Ukraine). The validity of results was checked using the control sera (Biocont C, Russia). Enzyme immunoassays and Doppler studies were used to investigate peripheral vasoregulation. Body mass index, intima-media thickness (IMT), pulse wave velocity (PWV), cardio-ankle vascular index (CAVI), endothelin-1 (ET-1), and endothelium-dependent vasodilation (EDVD) were determined. Results. All the studied indicators have directly or indirectly a negative impact, by deteriorating the function of the vessel wall. The found arterial structural changes suggest that there is an early atheromatous process in the arterial wall of hypertensive patients with gout. Addition of gout promotes endothelial dysfunction and worsens the course of hypertension. An elevation of indicators, such as PWV, CAVI, and ET-1 levels, has the poorest prognosis for the course of hypertension. Conclusion. The determination of CAVI, PWV, ET-1 levels, arterial stiffness index along with additional criteria, such as EDVD and IMT, may be used as criteria for a cardiovascular risk in hypertensive patients.

hypertension, gout, endothelin, peripheral arteries, Doppler study