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Influence of hypertension on early carotid artery remodeling
Gilles Chironi1, Jerome Gariepy, Nicolas Denarie
1Centre de Médecine Préventive Cardiovasculaire, Hôpital Broussais, Paris, France.
Insights
Hypertension increases carotid artery wall thickness and diameter. Antihypertensive therapy alters the relationship between carotid artery enlargement and wall thickening, indicating changes in large artery remodeling.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Early detection and understanding of arterial changes are crucial for managing hypertension.
- Large artery remodeling plays a significant role in the pathophysiology of hypertension.
Purpose of the Study:
- To investigate the impact of hypertension on early large artery remodeling.
- To analyze the relationship between carotid intima-media thickness (IMT) and diameter in hypertensive and normotensive individuals.
- To determine how antihypertensive therapy affects large artery remodeling.
Main Methods:
- Ultrasonographic measurement of carotid intima-media thickness (IMT) and diameter.
- Comparison of IMT and diameter between normotensive subjects, untreated hypertensive patients, and treated hypertensive patients.
- Statistical analysis to assess the association between diameter and IMT and its interaction with clinical groups, adjusting for covariates.
Main Results:
- Both IMT and diameter were significantly increased in hypertensive groups (treated and untreated) compared to normotensive individuals.
- A positive association between carotid diameter and IMT was observed in the overall population.
- The slope of the diameter-IMT relationship differed significantly between normotensive, untreated hypertensive, and treated hypertensive groups, being highest in the treated group, even after covariate adjustment.
Conclusions:
- Untreated hypertension does not alter the sensitivity of carotid artery enlargement to wall thickness increases.
- Antihypertensive therapy modifies the relationship between carotid artery enlargement and wall thickness compared to normotensive states.
- These findings suggest that antihypertensive treatment influences early large artery remodeling processes.
Objective:
We aimed to analyze the influence of hypertension on early large artery remodeling.
Methods And Results:
Carotid intima-media thickness (IMT) and diameter were measured ultrasonographically in 394 normotensive subjects and 327 untreated and 528 treated hypertensive patients. IMT and diameter were increased in hypertensive groups, treated or untreated, compared with the normotensive group (P<0.001). Positive association existed between diameter and IMT in the overall study population (P<0.001), and this association interacted with the category of clinical groups (P<0.01). The slope of the diameter-IMT relationship was different between normotensive, untreated hypertensive, and treated hypertensive groups (P<0.01), with higher value in the treated hypertensive group than in untreated hypertensive and normotensive groups (P<0.05, P<0.01). Adjustment for blood pressure, lipid-lowering therapy, or multiple covariates (age, sex, systolic and diastolic blood pressures, body mass index, lipid-lowering therapy, smoking, and previous cardiovascular disease) did not abolish the diameter-IMT slope difference between clinical groups (P<0.01).
Conclusions:
The sensitivity of carotid artery enlargement in response to increase in wall thickness was unchanged in untreated hypertension but altered by antihypertensive therapy compared with the normotensive condition.