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Prevalence of severe internal carotid artery disease in hypertensive elderly patients

R R Lewis1, T S Padayachee, R P Ariyanayagam

  • 1Department of Geriatric and General Medicine, Guy's Hospital, London, UK.

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|November 1, 1988
PubMed

Insights

Hypertension significantly increases the risk of severe internal carotid artery disease in elderly individuals. This non-invasive ultrasound study found no severe disease in normotensive volunteers.

Area of Science:

  • Vascular Medicine
  • Geriatric Medicine
  • Diagnostic Imaging

Background:

  • Internal carotid artery (ICA) disease is a major cause of stroke.
  • Hypertension is a known risk factor for cerebrovascular disease.
  • Non-invasive methods are crucial for assessing carotid artery stenosis.

Purpose of the Study:

  • To evaluate the prevalence of severe internal carotid artery lesions in hypertensive and normotensive elderly patients.
  • To compare the severity of ICA disease between elderly patients with and without a history of stroke.
  • To assess the utility of Doppler-shifted ultrasound in detecting significant carotid stenosis.

Main Methods:

  • Doppler-shifted ultrasound was employed as a non-invasive diagnostic tool.
  • Two groups were studied: 150 hypertensive patients (with and without stroke history) and 44 normotensive asymptomatic volunteers.
  • Prevalence of severe ICA lesions (pressure-dropping) was quantified in each group.

Main Results:

  • Severe ICA disease was detected in 14% of hypertensive patients without prior stroke and 23% of hypertensive patients with prior stroke.
  • No severe ICA disease was found in the normotensive elderly volunteers.
  • A statistically significant difference in severe carotid disease prevalence was observed between hypertensive and normotensive subjects.

Conclusions:

  • Hypertension is a significant independent risk factor for severe internal carotid artery disease in the elderly.
  • Doppler-shifted ultrasound is effective in identifying severe carotid lesions in at-risk populations.
  • Screening for carotid artery disease may be warranted in hypertensive elderly individuals.

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