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Structural changes in the heart and carotid arteries in hypertensive patients associated with cardiovascular risk
E Marchesi1, R Baiardini, P Centeleghe
1First Medical Clinic, University of Pavia, IRCCS Policlinico S. Matteo, Italy.
Insights
In hypertensive patients, heart structural changes and carotid artery wall thickness are linked. However, different factors influence these distinct cardiovascular changes.
Area of Science:
- Cardiology
- Vascular Biology
- Hypertension Research
Background:
- Hypertension is a major risk factor for cardiovascular disease.
- Structural changes in the heart (left ventricular hypertrophy) and arteries are common in hypertension.
- Understanding the relationship between these structural changes and cardiovascular risk factors is crucial.
Purpose of the Study:
- To investigate the relationship between cardiac structural changes and carotid artery wall thickness in hypertensive individuals.
- To identify cardiovascular risk factors associated with these structural alterations.
Main Methods:
- Seventy-six patients with mild-to-moderate hypertension were studied.
- Ambulatory blood pressure monitoring, echocardiography (left ventricular mass), and carotid ultrasonography (intima-media thickness) were performed.
- Multivariate and logistic regression analyses were used to assess relationships.
Main Results:
- Left ventricular mass index was significantly and independently related to carotid intima-media thickness.
- Age and HDL cholesterol influenced carotid thickness; systolic blood pressure and glycemia affected left ventricular mass.
- Posterior left ventricular wall thickness was a stronger predictor of carotid intima-media thickness than age or HDL cholesterol.
Conclusions:
- Carotid artery wall thickness and left ventricular mass are independently related in hypertensive patients.
- The primary determinants of structural cardiac and vascular changes in hypertension appear to differ.
Objective:
To estimate the relationship between structural changes in the heart and in the carotid arteries in hypertensives and to analyze the correlations between these structural changes and cardiovascular risk factors.
Methods:
We studied 76 subjects (39 men and 27 women, mean age 45+/-7 years) with mild-to-moderate untreated and uncomplicated hypertension. All of the subjects underwent ambulatory blood pressure monitoring, M-mode echocardiography for evaluation of their left ventricular mass and B-mode high-resolution ultrasonography to determine their carotid arterial wall thickness.
Results:
The mean intimal plus medial thickness of the common carotid artery was found to be related significantly and independently to the left ventricular mass indexed by the body surface area. In multivariate analysis, age and the high-density lipoprotein cholesterol level were related strongly to the intimal plus medial thickness, whereas the clinic systolic blood pressure, average night-time systolic blood pressure and glycemia were the most important determinants of the left ventricular mass index. Logistic regression analysis suggested that the thickness of the posterior left ventricular wall was a stronger predictor of the carotid intima-medial thickness than were age and the high-density lipoprotein cholesterol level.
Conclusion:
The carotid wall thickness and left ventricular mass of hypertensives are related independently; nevertheless the main determinants of structural cardiac and vascular changes are probably different.