Introduction: Blood pressure assessment is important for the evaluation of cardio-vascular disease and can be measured both invasively and noninvasively. Conventional noninvasive brachial blood pressure measurement has its own limitations. This study aimed to assess the relation between blood pressure indices and atherosclerotic burden in patients with obstructive coronary artery disease. Methods: A Cross sectional study was conducted at Cardiology Department of the Zagazig University Hospitals during the period from April 2018 to October 2018, This study included 90 consecutive stable patients with evidence of obstructive CAD as detected by elective coronary angiography. Patients were divided into 2 groups due to SYNTAX scores. Group I : >22 SYNTAX score, Group II : <22 SYNTAX score. Results: There is a significant positive correlation between SYNTAX score with invasive BP parameters (SBP, PP, FSP, FPP and PI) Although there is significant negative correlations between SYNTAX score with invasive DBP and FDP. LDL, non-invasive DBP, invasive central aortic SBP, DBP, PP, FSP, FDP, FPP, PI were significantly independently associated with high SYNTAX score. Conclusion:Invasive central aortic pressures were more predictive than peripheral pressures for the extent of coronary atherosclerosis which is identified by the presence of high SYNTAX Score. A definite significant association between both low DBP & high dynamic pulsatile components of central aortic pressure (SBP , FSP and pulsility indices ) and high SYNTAX Score in stable patients with obstructive CAD
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