ORIGINAL ARTICLES   

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

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.