Exploring carotid sonographic parameters associated with stroke risk among hypertensive stroke patients compared to
Atinuke M Agunloye1, Mayowa O Owolabi2
1Departments of Radiology (A.M.A.) and Medicine (M.O.O.), College of Medicine, University of Ibadan, Ibadan, Nigeria. tinuagunloye@yahoo.com tinuagunloye@comui.edu.
Insights
Hypertension increases stroke risk, especially in low-income nations. Common carotid artery diameter and end-diastolic velocity (EDV) measured by sonography are key indicators for stroke risk in hypertensive patients.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Medical Imaging
Background:
- Hypertension prevalence is rising globally, particularly in low- and middle-income countries, leading to increased stroke burden.
- Identifying reliable stroke biomarkers is crucial for developing targeted prevention strategies in these populations.
- Sonography offers an accessible and affordable imaging solution suitable for resource-limited settings.
Purpose of the Study:
- To identify carotid sonographic parameters associated with stroke risk in hypertensive patients.
- To evaluate the utility of sonography as a biomarker for stroke in hypertensive individuals.
- To inform stroke prevention programs in resource-poor regions.
Main Methods:
- A case-control study involving 135 hypertensive stroke patients and 117 matched controls.
- Measurement of carotid artery luminal diameter, intima-media thickness, peak systolic velocity (PSV), and end-diastolic velocity (EDV).
- Multivariate analysis to determine significant associations between carotid parameters and stroke risk.
Main Results:
- Higher common carotid artery diameter and intima-media thickness were linked to stroke.
- Lower peak systolic velocity (PSV) and end-diastolic velocity (EDV) in carotid arteries were associated with stroke.
- In multivariate analysis, common carotid artery diameter (>6.3 mm) and EDV (>21 cm/s) were significant predictors of stroke.
Conclusions:
- Common carotid artery diameter and end-diastolic velocity (EDV) are significant sonographic markers of stroke risk in hypertensive patients.
- These findings support the use of carotid sonography in risk stratification for stroke prevention.
- Sonographic parameters can aid in the development and evaluation of stroke prevention programs, especially in resource-limited settings.
Objectives:
Globally, and particularly in low- and middle-income countries, the prevalence of hypertension is increasing with a consequent rise in the burden of stroke. There is a need to identify biomarkers of stroke, which can be used to design stroke prevention programs in these populations. Sonography is an affordable and widely available imaging modality that is ideal for resource-poor countries. We conducted a case-control study to identify carotid sonographic parameters that may be associated with stroke risk among hypertensive patients.
Methods:
Selected demographic, clinical, and laboratory characteristics were collected from 135 consecutive African hypertensive stroke patients and compared with 117 age and sex-matched hypertensive patients with no clinical evidence of stroke, transient ischemic attacks, or ischemic heart disease (controls). The luminal diameter, intima-media thickness, peak systolic velocity (PSV), and end-diastolic velocity (EDV) of the common and internal carotid arteries were measured in all participants, and other carotid parameters, including pulsatility and resistive indices, were derived. Univariate, bivariate, and multivariate analyses were performed
Results:
Among hypertensive patients, carotid parameters significantly (P < .05) associated with stroke included a higher diameter and intima-media thickness as well as a lower PSV and EDV in the common carotid and proximal internal carotid arteries. However, the diameter (>6.3 mm; adjusted odds ratio [OR], 8.91; 95% confidence interval [CI], 2.18-36.34; P = .002) and EDV (>21 cm/s; adjusted OR, 0.15; 95% CI, 0.03-0.71; P = .017) of the common carotid artery were the only parameters associated with stroke in multivariate analysis.
Conclusions:
Among hypertensive patients, the common carotid artery diameter and EDV are significantly associated with stroke risk. These findings have implications for development and evaluation of stroke prevention programs.
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