P-260: Impact of blood pressure on coronary artery disease severity, endothelial damage and angiogenesis

Pulse pressure levels are now well established as useful measures of risk of coronary heart disease. We sought to investigate any relationship between pulse pressure levels, the severity of coronary artery disease and endothelial dysfunction and angiogenesis, processes involved in the pathogenesis of atherosclerosis. We studied 142 patients attending for elective coronary angiography (mean age 61.5±SD10.0 years, 101 males). Blood pressure recordings were performed prior to angiography. Following angiography disease severity was recorded by i) number of coronary vessels diseased (>50% stenosis) and ii) coronary atheromatous score (CAS)1. In addition, plasma levels of von Willebrand factor (vWf, a marker of endothelial dysfunction), vascular endothelial growth factor (VEGF, a marker of angiogenesis) and soluble VEGF receptor Flt-1 (sFlt-1) were measured by ELISA. The mean blood pressure for the 142 patients was 140/79±SD22/11mmHg. Median[interquartile range] pulse pressure was 60.0 [48.0-70.5]mmHg. There was no correlation between pulse pressure and CAS, number of vessels diseased, vWf, VEGF or sFlt-1. When patients were grouped into those above and below the median pulse pressure no significant differences were found in disease severity or plasma levels of vWf, VEGF or sFlt-1 (see table). As expected the mean age of patients was different between the 2 groups.TableDifferences between the two groups of patients defined by median pulse pressure. Pulse Pressure ≤60.0 mmHg Pulse Pressure >60.0 Hg P value Number of patients 79 63 Age (years) 58.6 ± 9.7 65.3 ± 9.2