Functional significance of coronary artery stenosis: the role of arterial hypertension (literature review)

Arterial hypertension (AH) is currently considered as the main risk factor for the development of atherosclerosis of the epicardial arteries, contributing to the formation of not only structural, but also functional changes in the coronary vessels, including at the level of microcirculation.Aim: To assess the influence of coronary microvascular dysfunction (CMD) of hypertensive origin on the functional significance of stenoses of the main coronary arteries according to measurements of fractional flow reserve (FFR), as well as to analyze the mechanisms of CMD formation in patients with coronary heart disease in combination with hypertension. The FFR measurement method is considered as a standard for making decisions about myocardial revascularization, which can increase the effectiveness of the intervention. However, the results available to date are still ambiguous, as evidenced by the results of numerous meta-analyses presented in the work. Equally important is the assessment of the independent unfavorable prognostic value of CMD, which makes it urgent to develop new targeted treatment methods that reduce the severity of these disorders.