M. Suurkula et al., ULTRASOUND EVALUATION OF ATHEROSCLEROTIC MANIFESTATIONS IN THE CAROTID-ARTERY IN HIGH-RISK HYPERTENSIVE PATIENTS, Arteriosclerosis and thrombosis, 14(8), 1994, pp. 1297-1304
The aim of this study was to evaluate whether high-risk hypertensive p
atients (n=137) had larger far-wall common carotid artery intima-media
thickness than a control group (n=37) and to study whether intima-med
ia thickness was related to other signs of atherosclerotic disease. Th
e results showed that intima-media thickness was significantly larger
in the hypertension group than in the control group. Lumen diameter an
d mean cross-sectional area of the intima-media complex were larger bo
th for hypertensive patients with a positive history of manifest clini
cal cardiovascular disease and for hypertensive patients with no such
history than in the control group. There was a significant relationshi
p between far-wall common carotid artery intima-media thickness and pl
aque status (visual scoring, no, small, moderate/large) in the carotid
artery region. In univariate analyses, low diastolic blood pressure a
nd high pulse pressure were both significantly related to plaque statu
s. In multivariate analyses, pulse pressure was significantly and inde
pendently related both to common carotid artery intima-media thickness
and to plaque status in the carotid artery region. In multivariate an
alyses, there was also an independent relationship between age and com
mon carotid artery intima-media thickness, between smoking status and
plaque status, and between a positive history of manifest clinical car
diovascular disease and plaque status. In conclusion, common carotid a
rtery intima-media thickness and lumen diameter were increased in elde
rly highrisk hypertensive patients, in whom more than one third of the
patients also had a moderate to large plaque in the carotid artery re
gion. Moderate to large plaques showed a relatively strong relationshi
p to manifest clinical cardiovascular disease and might thus be interp
reted as an indicator of clinically more serious disease than an incre
ase in common carotid artery intima-media thickness. Further studies a
re needed to investigate the value of common carotid artery intima-med
ia thickness as a marker of carotid atherosclerosis and as a surrogate
variable for coronary atherosclerosis.