Plasminogen activator inhibitor-1 and carotid intima-media thickening in patients with newly detected primary hypertension

Objective To investigate the correlation between ultrasonographically evalu ated intima-media thickness (IMT) of common carotid artery (CCA) and cardio vascular risk factors for subjects with newly detected, uncomplicated and u ntreated primary hypertension. Methods The study population consisted of 200 subjects (123 men and 77 wome n, aged 46 +/- 7.5 years). Blood pressure was measured in the clinical sett ing and by 24 h noninvasive ambulatory monitoring. Fasting levels of blood glucose, plasma lipids and lipoproteins, fibrinogen and plasminogen activat or inhibitor(PAI)1l were measured. Ultrasound examination included measurem ent of far-wall intima-media complex of CCA and morphologic evaluation of o ccurrence of plaques in carotid and femoral bifurcations. Results The prevalence of greater than normal IMT (mean IMT greater than or equal to 0.80 mm) was 22%. Significant univariate correlations to the dich otomy between normal and greater than normal mean IMT were detected for age , smoking, level of LDL cholesterol, level of PAI-I and total ultrasonograp hic score. Multivariate logistic regression analysis confirmed the associat ions between greater than normal mean IMT and plasma concentrations of LDL cholesterol and PAI-1 as well as total ultrasonographic score. Conclusion Greater than normal IMT of CCA was more strictly related to othe r cardiovascular risk factors than it was to blood pressure and was strongl y associated with the occurrence of atherosclerotic plaques in carotid and femoral arteries. The role of PAI-1 in intima-media thickening that is emer ging suggests that fibrinolytic balance is an important determinant of vess el-wall homeostasis in hypertensive patients. (C) 1999 Lippincott Williams & Wilkins.