ab21207

Systemic sclerosis is not associated with clinical or ambulatory blood pressure

N.A. Zakopoulos, V.Th. Kotsis, E.J. Gialafos, C.M. Papamichael, V.Ch. Pitiriga, D.N. Mitsibounas, M.E. Mavrikakis

Department of Clinical Therapeutics, Alexandra Hospital, University of Athens, National and Kapodestrial University, Athens, Greece.

ABSTRACT
Background
Raynaud's phenomenon is often the first symptom and occurs eventually in more than 95% of patients with systemic sclerosis (SSc). Angiographic studies disclose narrowing and obstruction of the digital arteries, which on autopsy histologic study show prominent subintimal connective tissue proliferation without inflammation, as well as adventitial fibrosis. It is also known that primary cardiac problems include pericarditis, left ventricular or biventricular failure, serious supraventricular or ventricular arrhythmias emerge in patients with SSc. It is not known if these patients present hypertension or hypotension and which parameter of the ambulatory blood pressure may influence such a disease course.

Methods
A total of 85 subjects underwent clinical blood pressure (BP) readings, 24-hour ambulatory BP monitoring, left ventricular assessment by echocardiography and measurement of intima media thickness (IMT) of the right-left internal carotid arteries (RICA and LICA) and right-left common carotid arteries (RCCA and LCCA). The population consisted of 40 subjects with SSc according to the criteria of the American College of Reumatology (SCL-group) who were not receiving any antihypertensive treatment and 45 healthy volunteers (control group). The two groups did not differ in age.

Results
Clinical systolic and diastolic blood pressure, clinical heart rate, mean 24h systolic blood pressure, SD systolic blood pressure, mean 24h diastolic blood pressure, SD 24h diastolic blood pressure, mean 24h heart rate, SD 24h heart rate, pulse pressure 24h, serum glucose, cholesterol, triglycerides, hdl, ldl, creatinine, urea, potassium and natrium did not statistically significant differ between the two groups. Furthermore, the left ventricular mass/BSA and IMT of both carotid arteries did not show a statistically significant difference between the groups.

Conclusion
Systemic sclerosis is not associated with clinical blood pressure or the parameter of 24h blood pressure monitoring.

Key words
Scleroderma, ambulatory blood pressure monitoring.

Please address correspondence to: Vasilios Kotsis, MD, Department of Clinical Therapeutics, Alexandra Hospital, Vas. Sofias 80 and Lourou str., 11528, Athens, Greece
E-mail: kotsisva@hol.gr