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Carotid intima-media thickness and plaque in borderline hypertension
C Lemne1, T Jogestrand, U de Faire
1Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
Insights
Men with borderline hypertension show early signs of vascular changes like increased intima-media thickness and plaque in carotid arteries. These changes are linked more to general atherosclerotic risk factors than blood pressure alone.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Hypertension Research
Background:
- Borderline hypertension may precede established hypertensive disease.
- Early detection of vascular changes is crucial for cardiovascular risk assessment.
Purpose of the Study:
- To compare carotid artery intima-media thickness and plaque occurrence in men with borderline hypertension versus normotensive controls.
- To investigate the relationship between these vascular changes and traditional atherosclerotic risk factors.
Main Methods:
- B-mode ultrasonography used to measure carotid artery intima-media thickness and plaque.
- Comparison between 73 men with borderline hypertension (DBP 85-94 mm Hg) and 72 normotensive controls (DBP 80 mm Hg).
- Evaluation of risk factors including age, smoking, lipoproteins, and insulin levels.
Main Results:
- Borderline hypertensive group showed increased intima-media thickness (P=.07), particularly in the right carotid artery (P<.05).
- Higher prevalence of plaque in borderline hypertensives (26% vs 16%), more pronounced on the right side (P<.05).
- Age and HDL cholesterol correlated with intima-media thickness; age was the sole determinant for plaque presence.
Conclusions:
- Vascular structural changes are present in borderline hypertension, influenced by atherosclerotic risk factors.
- Asymmetrical development of atherosclerotic lesions in left and right carotid arteries may occur.
- Measuring both carotid arteries is important for accurate assessment of intima-media thickness and plaque.
Background And Purpose:
In this study, we investigated intima-media thickness and plaque occurrence in the carotid arteries of men with borderline hypertension compared with that in normotensive control subjects and investigated the relations of these variables to atherosclerotic risk factors.
Methods:
Using B-mode ultrasonography, we compared carotid artery intima-media thickness and plaque occurrence in men with borderline hypertension (diastolic blood pressure of 85 to 94 mm Hg, n = 73) with that in age-matched normotensive control subjects (diastolic blood pressure of 80 mm Hg, n = 72). We evaluated the relationships of intima-media thickness and plaque occurrence to atherosclerotic risk factors such as age, smoking, lipoprotein levels, and fasting insulin levels.
Results:
The borderline hypertensive group exhibited a slight increase in overall intima-media thickness (0.73 versus 0.69 mm, P = .07), which was most evident in the right carotid artery (0.72 versus 0.67 mm, P < .05). There were more borderline hypertensive subjects with plaque (26% versus 16%, NS), again more evident on the right side (18% versus 6%, P < .05). Age and high-density lipoprotein cholesterol were consistently related to intima-media thickness (t = 1.94 to 3.24 and t = -2.25 to -2.69, respectively, P < .05), whereas age was the only significant determinant for plaque/nonplaque (F = 6.4, P < .05). In addition, there was a significant difference in intima-media thickness between the right and left carotids, irrespective of group (F = 4.43, P < .05).
Conclusions:
Our results indicate that vascular structural changes occur even in borderline hypertension, although this seems more related to general atherosclerotic risk factors than to blood pressure alone. Additionally, a possible difference in the development of atherosclerotic lesions of the left and right carotid arteries is suggested, emphasizing the importance of measuring and reporting values from both sides when studying carotid intima-media thickness and plaque occurrence.