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Association between common carotid artery diameter and target organ damage in essential hypertension
Yan Yang1, Yan Wang1, Jianzhong Xu1
1Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine.
Insights
Common carotid artery diameter (CCA-D) is a significant predictor of target organ damage (TOD) in essential hypertension. Increased CCA-D correlates with left ventricular hypertrophy, arterial stiffness, and kidney damage, highlighting its role as an independent risk factor.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Vascular Biology
Background:
- Essential hypertension is a leading cause of cardiovascular morbidity and mortality.
- Target organ damage (TOD) is a critical determinant of prognosis in hypertensive patients.
- Common carotid artery diameter (CCA-D) is a potential indicator of vascular changes in hypertension.
Purpose of the Study:
- To investigate the relationship between common carotid artery diameter (CCA-D) and target organ damage (TOD) in essential hypertension.
- To determine if height-adjusted CCA-D is an independent risk factor for TOD in hypertensive individuals.
Main Methods:
- 200 essential hypertensive patients were enrolled and categorized based on height-adjusted mean CCA-D.
- Evaluated parameters included left ventricular mass index (LVMI), carotid intima-media thickness, pulse wave velocity (PWV), and urinary albumin/creatinine ratio.
- Statistical analyses, including correlation and multivariable regression, were performed to assess associations.
Main Results:
- Patients with higher CCA-D/height ratios exhibited significantly higher LVMI, prevalence of left ventricular hypertrophy (LVH), carotid artery sclerosis, arterial stiffness, and microalbuminuria.
- CCA-D showed significant correlations with LVMI, PWV, and urinary albumin/creatinine ratio after adjusting for cardiovascular risk factors.
- Multivariable analysis confirmed that height-adjusted mean CCA-D was independently correlated with individual TODs and the overall number of TODs.
Conclusions:
- Height-adjusted mean CCA-D is an independent risk factor for target organ damage in essential hypertension.
- CCA-D serves as a valuable marker for assessing the extent of TOD, including cardiac, vascular, and renal damage.
- These findings underscore the importance of monitoring CCA-D in hypertensive patients for risk stratification and management.
Objectives:
To investigate the relationship between common carotid artery diameter (CCA-D) and target organ damage (TOD) in essential hypertension.
Methods And Results:
A total of 200 essential hypertensive patients were enrolled (mean age 62.5 ± 9.5, men 59.0%) and were classified into two groups by the height-adjusted mean median of CCA-D: patients with CCA-D/height less than 3.905 mm/m (n = 100, 50%) and patients with CCA-D/height more than 3.905 mm/m (n = 100, 50%). Patients with CCA-D/height more than 3.905 mm/m have higher left ventricular mass index (LVMI) (P < 0.001) and higher prevalence of left ventricular hypertrophy (LVH) (P < 0.001), higher mean common carotid intima-media thickness (P = 0.008) and higher prevalence of carotid artery sclerosis (P = 0.03), higher pulse wave velocity (PWV) (P < 0.001) and higher prevalence of increased arterial stiffness (P = 0.01), higher urinary albumin/creatinine ratio (P = 0.001) and higher prevalence of microalbuminuria (P = 0.02) and greater number of TODs (P < 0.001) compared with the patients with CCA-D/height less than 3.905 mm/m. CCA-D was significantly correlated with LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio (r = 0.299, P < 0.001; r = 0.212, P = 0.007; r = 0.224, P = 0.005, respectively) after adjusting for cardiovascular risk factors. Multivariable stepwise linear regression analysis showed that number of TODs as well as individual TOD, including LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio, were independently correlated to height-adjusted mean CCA-D (all P < 0.05).
Conclusion:
Height-adjusted mean CCA-D was an independent risk factor for individual TOD, including LVMI, PWV and urinary albumin/creatinine ratio, as well as overall number of TODs in essential hypertension.