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Effects of hypertension on intimal-medial thickness, left ventricular mass and aortic distensibility
P Guarini1, C Tedeschi, G Giordano
12nd Division of Cardiology, Ascalesi Hospital, Naples, Italy.
Insights
Hypertension is linked to thicker carotid arteries and enlarged heart muscle. These vascular and cardiac changes, detected non-invasively, correlate with reduced arterial compliance in hypertensive patients.
Area of Science:
- Cardiology
- Vascular Medicine
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Understanding the vascular and cardiac structural changes associated with hypertension is crucial for risk stratification and management.
Purpose of the Study:
- To evaluate arterial distensibility, common carotid artery intimal-medial thickness, and left ventricular mass in hypertensive patients.
- To explore correlations among these parameters in the hypertensive state.
Main Methods:
- B-mode echotomography of the extracranial carotid tract and M-mode echocardiography were performed on 89 hypertensive and 76 normotensive subjects.
- Standard diagnostic criteria were used to define hypertension (systolic BP >= 160 mmHg or diastolic BP > 90 mmHg).
Main Results:
- Hypertensive patients exhibited significantly greater common carotid artery intimal-medial thickness (0.90-0.92 mm) compared to normotensive subjects (0.64 mm, p < 0.001).
- Interventricular septum thickness was significantly increased in hypertensive individuals (12.1 mm) versus normotensive controls (9.1 mm, p < 0.001).
Conclusions:
- Hypertensive subjects demonstrate increased common carotid artery intimal-medial thickness, associated with left ventricular hypertrophy and reduced arterial compliance.
- Non-invasive vascular ultrasonography and echocardiography can identify cardiac and vascular abnormalities in hypertension.
Abstract:
The aim of the study was to evaluate arterial distensibility, intimal-medial thickening of the common carotid artery, left ventricular mass and the eventual correlations among these parameters in the hypertensive state. Our study population consisted of 89 hypertensive patients aged 35 to 80 years (mean age 60.8 +/- 10.6 years), and 76 normotensive subjects aged 45 to 85 years (mean age 61.2 +/- 11.1 years). Those patients constantly presenting systolic blood pressure values > or = 160 mmHg or diastolic blood pressure > 90 mmHg were diagnosed as hypertensive. Each patient underwent a B-mode echotomographic examination of the extracranial carotid tract performed with a Vingmed CFM 750 echotomographer with a 7.5 MHz probe and M-mode echocardiography with a Vingmed CFM 750 device equipped with a 3.0 MHz transducer. The results show the intimal-media thickness value in hypertensive patients (0.90 +/- 0.22 mm on the right and 0.92 +/- 0.22 mm on the left), was significantly greater than that in normotensive subjects (0.64 +/- 0.13 mm on the right and 0.64 +/- 0.13 mm on the left, p < 0.001); in hypertensive subjects, interventricular septum thickness (12.1 +/- 1.25 mm) was significantly greater than that in normotensive patients (9.1 +/- 0.77 mm, p < 0.001). In conclusion, we can say that hypertensive subjects have higher values of common carotid artery intimal-medial thickness than normotensives and that this finding is associated with the presence of left ventricular hypertrophy and with a reduction in arterial compliance. Vascular ultrasonography, as well as echocardiography and arterial mechanography can show, in hypertensive subjects, cardiac and vascular abnormalities in a non invasive way.