CAROTID INTIMA-MEDIA THICKNESS AND PLAQUE IN BORDERLINE HYPERTENSION

Background and Purpose In this study, we investigated intima-media thi ckness and plaque occurrence in the carotid arteries of men with borde rline 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 caroti d artery intima-media thickness and plaque occurrence in men with bord erline hypertension (diastolic blood pressure of 85 to 94 mm Hg, n=73) with that in age-matched normotensive control subjects (diastolic blo od pressure of 80 mm Hg, n=72). We evaluated the relationships of inti ma-media thickness and plaque occurrence to atherosclerotic risk facto rs such as age, smoking, lipoprotein levels, and fasting insulin level s. Results The borderline hypertensive group exhibited a slight increa se in overall intima-media thickness (0.73 versus 0.69 mm, P=.07), whi ch 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 consiste ntly 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 dete rminant 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 bord erline hypertension, although this seems more related to general ather osclerotic risk factors than to blood pressure alone. Additionally, a possible difference in the development of atherosclerotic lesions of t he left and right carotid arteries is suggested, emphasizing the impor tance of measuring and reporting values from both sides when studying carotid intima-media thickness and plaque occurrence.