Authors:

Chan Huy Ha

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About Paper:

Background: Hypertension (HTN) is a major risk factor for coronary artery disease. Previous research demonstrated that laminar flow protects the endothelium, whereas turbulent flow damages it and initiates atherosclerosis. This study aimed to determine the blood pressure (BP) threshold beyond which turbulence and retrograde flow develop, potentially triggering intimal injury and plaque formation. Methods: A total of 50 patients were divided into two groups: Group A with controlled BP (<120/75 mmHg) and Group B with uncontrolled BP (>160/105 mm Hg). Dynamic coronary and iliac angiography was performed with 15 frames per second (0.06 seconds per frame). Flow was visualized as white blood entering over a black contrast background. The duration of antegrade, retrograde, and turbulent flow (collision) was measured. Turbulence was defined as swirling or mixing of contrast and blood following retrograde-antegrade collision. Results: In Group A (n=20), 90% of patients showed no retrograde flow in iliac or coronary arteries, and collision duration was brief (<0.12 seconds). In Group B (n=30), retrograde flow in the iliac artery was observed with prolonged collision (>0.24 seconds), and coronary turbulence lasted up to 0.18 seconds (p < 0.05 vs. Group A). The sites of turbulence corresponded to known plaque-prone regions in previous studies. Conclusion: Uncontrolled HTN produces prolonged retrograde and turbulent flow, potentially injuring the endothelium and initiating atherosclerosis. Controlled BP (<120/75 mmHg) was associated with laminar flow and minimal collision. These findings suggest that lower BP may protect † Presenting Undergrad Author; ‡ Contributing Undergrad Author; * Undergrad Acknowledgment against flow-related vascular injury. Larger clinical trials are warranted to define optimal BP targets for atheroprotection. Keywords: Atheroprotection; Hypertension; Coronary Artery Disease; Laminar Flow; Retrograde-Antegrade Collision

Source:

Purdue University / 2025

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Co-authors:

Chan Huy Ha