Arterial wall thickening at different sites and its association with left ventricular hypertrophy in newly diagnosed essential hypertension

The impact of hypertension on vascular structure at different arterial site s and the relation of vascular hypertrophy with left ventricular (LV) hyper trophy in the early stages of essential hypertension are unclear. In 96 new ly diagnosed, never-treated, uncomplicated hypertensive subjects aged < 55 years (43 +/- 9 years, 68 men, clinic blood pressure 152/99 mm Hg, 24-h blo od pressure 135/89 mm Hg), we measured LV mass (M-mode echocardiography) an d intima-media thickness (IMT) of the carotid and femoral arteries (high-re solution B-mode ultrasound). The average of 24 carotid and 24 femoral IMT r eadings (common and internal carotid or common and superficial femoral, rig ht and left side, far and near wall, three sampling points per segment) was analyzed. Carotid and femoral IMT were strongly related to each other (r = 0.77). Subjects with LV hypertrophy (n = 33) had a greater IMT at the caro tid (0.84 +/- 0.2 v 0.71 +/- 0.2 mm, P < .0001) and femoral (0.77 +/- 0.1 v 0.64 +/- 0.1 mm, P < .0001) level. Carotid IMT showed a positive correlati on with LV mass (r = 0.46) and age (r = 0.38), and an inverse one with high -density lipoprotein (HDL) cholesterol (r = -0.26). Femoral IMT was associa ted positively to LV mass (r = 0.50), age (r = 0.33) and triglycerides (r = 0.29), and inversely to HDL-cholesterol (r = -0.33). The association betwe en IMT (both carotid and femoral) and LV mass held after controlling for ag e and other confounders in a multiple regression analysis. In summary, in t he early stages of hypertension arterial wall thickening appears to be a di ffuse process, which occurs in parallel at the carotid and femoral level an d shows a positive association with LV hypertrophy. (C) 2000 American Journ al of Hypertension, Ltd.