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International Angiology 2002 March;21(1):70-77

Copyright © 2003 EDIZIONI MINERVA MEDICA

lingua: Inglese

Dependence of morphological changes of the carotid arteries on essential hypertension and accompanying risk factors

Zizek B., Poredos P.

From the Department of Angiology, University Medical Centre, Ljubljana, Slovenia


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Background. Aims: to eval­u­ate mor­pho­log­i­cal chang­es (inti­ma-­media thick­ness, ­IMT) of ­the carot­id arter­ies in ­patients ­being treat­ed ­for essen­tial hyper­ten­sion (EH), ­and to dis­cov­er wheth­er ­this abnor­mal­ity ­can be detect­ed in nor­mo­ten­sive off­spring of sub­jects ­with EH (famil­ial ­trait, FT); ­and to inves­ti­gate ­the inter­re­la­tion­ship ­between ­IMT ­and accom­pa­ny­ing ­risk fac­tors.
Methods. Experimental ­design: ­cross-sec­tion­al ­study. Setting: angi­ol­o­gy depart­ment, university teach­ing hos­pi­tal. Subjects: ­the ­study encom­passed 172 sub­jects, of ­whom 46 ­were treat­ed hyper­ton­ics ­aged 40-55 (49) ­years, ­and 44 ­age ­matched, nor­mo­ten­sive vol­un­teers as con­trols. We ­also inves­ti­gat­ed 41 nor­mo­ten­sives ­with FT ­for essen­tial hyper­ten­sion ­aged 20-30 (25) ­years ­and 41 ­age- ­and ­sex-­matched con­trols with­out FT. Interventions: ­the hyper­ten­sive sub­jects ­were ­being treat­ed ­either ­with ­long-act­ing cal­cium-chan­nel antag­o­nists or ­ACE-inhib­i­tors. Measures: ­using ­high res­o­lu­tion ultra­sound, ­IMT of ­the carot­id bifur­ca­tion ­and of ­the com­mon carot­id ­artery ­was meas­ured.
Results. In ­the hyper­ten­sives, ­the ­mean ­IMT ­was great­er ­than ­that in ­the con­trols (0.92 (0.10) mm vs 0.72 (0.07) mm; p<0.00005). The ­IMT ­was inde­pen­dent­ly relat­ed to accom­pa­ny­ing ­risk fac­tors: a pos­i­tive fam­i­ly his­to­ry of hyper­ten­sion, ­age of ­the ­patient, dura­tion of EH ­and ­the lev­el of sys­tol­ic/dia­stol­ic ­blood pres­sure (BP), ­body ­mass ­index ­and ­total/­LDL-cho­les­te­rol. In sub­jects ­with FT, ­IMT ­was ­also great­er com­pared to ­the con­trol ­group (0.60 (0.05) mm vs 0.55 (0.04) mm; p<0.00005). ­IMT ­was ­not relat­ed to BP val­ues.
Conclusions. In treat­ed essen­tial ­patients ­with ­the EH, ­the ­IMT ­was ­increased. Individuals ­with FT ­also ­had great­er ­IMT in ­the ­absence of ele­vat­ed BP. The ­IMT in hyper­ten­sives ­was relat­ed to accom­pa­ny­ing ­risk fac­tors, ­which ­could be pathog­e­net­ic deter­mi­nants of EH ­and/or ­its com­pli­ca­tions.

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