G. Schillaci et al., Optimizing assessment of carotid and femoral intima-media thickness in essential hypertension, AM J HYPERT, 14(10), 2001, pp. 1025-1031
Large artery intima-media thickness (IMT) is considered an integrated marke
r for the total individual burden of arteriosclerosis, and a graded index f
or cardiovascular risk. However, several different aggregate indexes of IMT
on B-mode ultrasound have been used by various investigators, and the opti
mal number of IMT readings is currently unsettled. In 128 newly diagnosed,
never treated, uncomplicated hypertensive subjects aged <55 years (43 <plus
/minus> 9 years, blood pressure [BP] 152/99 mm Hg), we measured left ventri
cular mass (M-mode echocardiography, average of five or more measurements)
and IMT of common carotid and common femoral arteries. For each segment, 12
IMT measurements were performed, and the average of 1 and 3 readings (righ
t far wall), 6 readings (right side), and 12 readings (right and left side,
far and near wall, 3 sampling points) was analyzed. The relation of IMT wi
th left ventricular mass increased progressively with increasing number of
readings, from 0.35 (1 reading) to 0.51 (12 readings) for common carotid ar
tery, and from 0.31 to 0.56 for common femoral artery (both P < .001). For
each 0.2-mm increase in common femoral IMT, the age-adjusted relative risk
of having left ventricular hypertrophy was 1.31 for 1 reading, and increase
d up to 3.59 for the average of 12 readings. In summary, the association of
IMT with left ventricular mass depends strongly on the number of IMT readi
ngs. The average of several readings in each segment, including right and l
eft side and far and near wall, carries the closest association to left ven
tricular mass, and should be preferred for clinical purposes in hypertensiv
e subjects. Am J Hypertens 2001;14: 1025-1031 (C) 2001 American Journal of
Hypertension, Ltd.