Association between pulse pressure, carotid intima–media thickness and carotid and/or iliofemoral plaque in hypertensive patients

Abstract

Increased common carotid artery intima-media thickness (CCA-IMT) and carotid and/or iliofemoral (C/IF) plaque are frequent in subjects treated for hypertension, but their association with pulse pressure (PP) has rarely been studied. Using ultrasound techniques, CCA-IMT and C/IF plaques were studied in 323 hypertensive subjects, who were classified into four groups according to the adequacy of blood pressure (BP) control (systolic BP (SBP) o140 mmHg and diastolic BP (DBP) o90 mmHg) and PP (high or low). After adjustment for confounding variables, an increase in CCA-IMT was the only factor significantly and independently associated with high PP, irrespective of the effectiveness of blood pressure control and of antihypertensive drug treatment. CCA-IMT correlated with age, PP, waist-to-hip ratio, tobacco consumption, and heart rate. C/IF plaques correlated with age, tobacco consumption, diabetes mellitus, and dyslipidaemia. To conclude, even with SBPo140 mmHg and DBPo90 mmHg on treatment, hypertensive subjects may have increased CCA-IMT values and C/IF plaque. Four cardiovascular risk factors seem to be involved in these alterations, namely tobacco consumption, dyslipidaemia, diabetes and increased PP. Only the latter factor does not have a standardized effective treatment.

Characteristics of pulse wave velocity in elastic and muscular arteries

“…Measurements were taken on the left common carotid artery, 2 cm from the bifurcation, and always performed on plaque-free arterial segments. IMT was automatically determined from changes of density on the section perpendicular to the vessel wall using specific software [12,13]. In our previous publication, the correlation coefficients for interobserver and intraobserver variability in IMT measurement by the Kontron ultrasound system were 0.71 and 0.77, respectively [12].…”

Gender difference in cardiovascular risk factors in the elderly with cardiovascular disease in the last stage of lifespan: The PROTEGER study

“…Measurements were taken on the left common carotid artery, within 2 cm from the bifurcation, and always performed on plaque-free arterial segments. IMT was automatically determined from changes of density on the section perpendicular to the vessel wall using specific software [17,18]. Data on reproducibility have been previously published [18].…”

Novel Concepts of Statin Therapy for Cardiovascular Risk Reduction in Hypertension

“…Increased common carotid artery intima-media thickness (CCA-IMT) is frequent in subjects treated for hypertension, even with SBP<140 mmHg and DBP<90 mmHg on treatment, hypertensive subjects may have increased CCA-IMT values and the four cardiovascular risk factors that seem to be involved in these alterations include namely tobacco consumption, dyslipidaemia, diabetes and increased pulse pressure [114].…”