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[Correlation between myocardial ischemia and carotid atherosclerosis in hypertensive patients]
Tian-hui You1, Ya-qin Lu, Zuo-jun Tian
1Nursing School of Guangdong Pharmaceutical University, Guangzhou 510310, China. youth888cn@yahoo.com.cn
Insights
Carotid plaque formation is a major risk factor for myocardial ischemia in hypertensive patients. However, common carotid artery intima-media thickness and plaque scores are not accurate predictors of this condition.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a significant risk factor for cardiovascular diseases, including myocardial ischemia.
- Carotid atherosclerosis, characterized by plaque formation and intima-media thickness (IMT), is associated with systemic vascular health.
- Understanding the link between carotid atherosclerosis and myocardial ischemia in hypertensive patients is crucial for risk stratification.
Purpose of the Study:
- To investigate the correlation between myocardial ischemia and carotid atherosclerosis in patients with hypertension.
- To identify risk factors for myocardial ischemia in this patient population.
- To evaluate the predictive value of carotid atherosclerosis markers for myocardial ischemia.
Main Methods:
- Retrospective analysis of 85 hypertensive patients without coronary artery disease.
- Classification into myocardial ischemia and ischemia-free groups based on treadmill exercise testing.
- Assessment of common carotid artery intima-media thickness (IMT), Crouse plaque score, intraventricular septum, and left atrium thickness.
- Statistical analyses including univariate, multivariate, and ROC curve analyses.
Main Results:
- Carotid plaque formation was identified as a major risk factor for myocardial ischemia (OR=4.982, P=0.004).
- Patients with carotid plaques had a significantly higher incidence of myocardial ischemia (Chi2=9.317, P=0.002).
- Myocardial ischemia correlated positively with intraventricular septum and left atrium thickness; IMT correlated with intraventricular septum thickness.
Conclusions:
- Carotid plaque formation is a significant risk factor for myocardial ischemia in hypertensive individuals.
- While associated with myocardial ischemia, common carotid artery IMT and Crouse plaque score showed limited accuracy in predicting its presence in hypertensive patients.
- Further research may be needed to identify more precise predictive markers for myocardial ischemia in this population.
Objective:
To analyze the correlation between myocardial ischemia and carotid atherosclerosis in hypertensive patients.
Methods:
The clinical data were collected from 85 hospitalized hypertensive patients admitted between May 2005 and September 2008 without the complication of coronary artery disease as confirmed by cardiac computed tomographic angiography (CTA). According to the results of treadmill exercise test, the patients were divided myocardial ischemia group and ischemia-free group. Univariate and multivariate analyses were used to screen the risk factors of myocardial ischemia. The correlations were analyzed between myocardial ischemia, common carotid artery intima-media thickness (IMT), Crouse score of the carotid plaque, thickness of the intraventricular septum and left artrium. The receiver operating characteristic (ROC) curves were used to evaluate the sensitivity and specificity of IMT and Crouse score in predicting the presence of myocardial ischemia in hypertensive patients.
Results:
Carotid plaque formation was identified as the major risk factor of myocardial ischemia in hypertensive patients (OR=4.982, P=0.004). The incidence of myocardial ischemia in the hypertensive patients with carotid plaques was significantly higher than that in the patients without the plaque (Chi2=9.317, P=0.002). Myocardial ischemia in hypertensive patients was positively correlated to the thickness of the intraventricular septum (r=0.362, P=0.001) and left artrium (r=0.298, P=0.009), and the IMT of the common carotid artery was positively correlated to the thickness of the intraventricular septum (r=0.231, P=0.045). The area under cure (AUC) of the ROC curve of Crouse score was 0.726-/+0.061 in predicting the presence of myocardial ischemia in the hypertensive patients (P=0.001), and that of IMT was 0.682-/+0.061 (P=0.006).
Conclusion:
Carotid plaque formation is the major risk factor of myocardial ischemia in hypertensive patients and shows a positive correlation to the onset of myocardial ischemia, but both the common carotid artery IMT and the Crouse score of the carotid plaque are not accurate markers for predicting myocardial ischemia in patients with hypertension.
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