Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound

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Yuting Tan1, Fang Nie1, Guode Wu2

  • 1Ultrasound Medical Center, Lanzhou University Second Hospital.

Journal of Atherosclerosis and Thrombosis
|April 8, 2021
PubMed

Insights

H-type hypertension is linked to increased intraplaque neovascularization (IPN), a marker of vulnerable carotid plaques. This suggests managing homocysteine levels is crucial alongside blood pressure control for stroke prevention.

Area of Science:

  • Cardiovascular Medicine
  • Neurology
  • Vascular Biology

Background:

  • H-type hypertension is associated with carotid atherosclerotic plaques and stroke.
  • Neovascularization within plaques is a key factor in plaque vulnerability.
  • The specific link between H-type hypertension and plaque vulnerability, particularly intraplaque neovascularization (IPN), is not well understood.

Purpose of the Study:

  • To investigate the influence of H-type hypertension on intraplaque neovascularization (IPN) in patients with carotid plaques.
  • To explore the correlation between H-type hypertension and the degree of plaque enhancement, a surrogate for IPN.

Main Methods:

  • 235 patients with carotid plaques were categorized into four groups: H-type hypertension, simple hypertension, isolated hyperhomocysteinemia, and control.
  • Contrast-enhanced ultrasound (CEUS) was used to evaluate IPN via semi-quantitative visual grading (grade 1 vs. grade 2).
  • Logistic regression analysis was employed to determine the association between H-type hypertension and plaque enhancement.

Main Results:

  • Patients with CEUS grade 2 plaques (indicating higher IPN) showed a greater frequency of ischemic stroke, hypertension, and H-type hypertension compared to those with grade 1 plaques.
  • H-type hypertension was independently associated with the degree of plaque enhancement (multivariate-adjusted OR: 3.036, 95% CI: 1.258-7.329).
  • No significant differences in plaque morphology, echogenicity, or stenosis severity were observed based on plaque enhancement levels.

Conclusions:

  • H-type hypertension is significantly associated with increased plaque enhancement, suggesting it promotes intraplaque neovascularization.
  • These findings highlight the role of H-type hypertension in plaque vulnerability and stroke risk.
  • Simultaneous management of blood pressure and homocysteine levels may be crucial for treating vulnerable plaques and preventing stroke.
Abstract

Keywords:
Carotid atherosclerotic plaqueContrast-enhanced ultrasoundH-type hypertensionIschemic strokeNeovascularization

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