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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
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Published on: April 23, 2021

Early detection of silent ischemia and diastolic dysfunction in asymptomatic young hypertensive patients

Ragab A Mahfouz1, Mohammad A El Tahlawi, Amr A Ateya

  • 1Cardiology Department, Zagazig University Hospitals, Zagazig, Egypt.

Echocardiography (Mount Kisco, N.Y.)
|March 24, 2011
PubMed

Insights

Asymptomatic young hypertensive patients show increased carotid-intima media thickness (IMT), a marker of atherosclerosis. This elevated IMT is linked to reduced coronary flow reserve and early diastolic dysfunction, indicating subclinical cardiovascular disease.

Area of Science:

  • Cardiology
  • Vascular Biology
  • Hypertension Research

Background:

  • Coronary artery disease (CAD) is associated with increased carotid-intima media thickness (IMT), a marker of atherosclerosis.
  • This relationship is understudied in asymptomatic individuals with CAD risk factors.

Purpose of the Study:

  • To investigate the correlation between carotid-IMT, coronary flow reserve (CFR), and cardiac function in young, asymptomatic hypertensive subjects.
  • To identify subclinical atherosclerosis and diastolic dysfunction in this population.

Main Methods:

  • The study included 82 asymptomatic young hypertensive patients and 78 healthy controls.
  • Carotid-IMT was measured using B-mode ultrasonography.
  • Treadmill exercise tests, CFR assessments, and echo Doppler studies were conducted on all participants.

Main Results:

  • Hypertensive subjects exhibited significantly higher carotid-IMT and lower coronary flow velocity reserve compared to controls (P < 0.01 and P < 0.003, respectively).
  • Increased carotid-IMT correlated with reduced CFR (r = -0.843, P < 0.001) and impaired diastolic function (E/e″, r = -0.512, P < 0.003) in hypertensives.
  • Carotid-IMT also showed a significant correlation with a family history of hypertension (r = 0.653, P < 0.002).

Conclusions:

  • Carotid-IMT is significantly elevated in asymptomatic young hypertensive patients, suggesting subclinical atherosclerosis.
  • Increased carotid-IMT is associated with myocardial ischemia, reduced CFR, and incipient diastolic dysfunction.
  • Carotid-IMT can serve as an indicator for subclinical atherosclerosis and diastolic dysfunction in hypertensive individuals with CAD risk factors.
Abstract

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