An increased carotid intima-media thickness (IMT) has been found to be
associated with a number of cardiovascular risk factors such as age,
hypertension, cigarette smoking, hypercholesterolaemia and left ventri
cular hypertrophy. Our objective was to assess whether carotid intima-
media thickness in hypertensive patients could be reduced by antihyper
tensive therapy. Methods: 13 hypertensive patients, 10 previously untr
eated, were examined using carotid ultrasonography and echocardiograph
y at baseline and then at 8 weeks and 39 weeks after commencement of a
ntihypertensive therapy with ramipril and the second-line addition of
felodipine. Results: By the end of the study significant regression of
IMT (0.1(0.05-0.16) mm, F-value 10.2, P < 0.01) and left ventricular
mass index had occurred (25(10.7-39.3) g/m(2), F-value 9.7, P < 0.01).
The reduction in IMT was significantly related to the reduction in me
an arterial pressure, r = 0.55, P = 0.05). Conclusion: Antihypertensiv
e therapy with ramipril and felodipine causes regression of IMT in hyp
ertensive patients, probably chiefly through blood pressure reduction.
Large prospective studies are required to assess whether a reduction
in IMT results in a reduction in morbidity and mortality.