ULTRASOUND EVALUATION OF ATHEROSCLEROTIC MANIFESTATIONS IN THE CAROTID-ARTERY IN HIGH-RISK HYPERTENSIVE PATIENTS

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.