Carotid Intima-Media Thickness in Asymptomatic Patients With Arterial Hypertension Without Clinical Cardiovascular Disease: Relation With Left Ventricular Geometry and Mass and Coexisting Risk Factors

Abstract

We analyzed in NYHA I hypertensives the interactions between Carotid Intima-Media Thickness (IMT), Hypertension and Cardiovascular (CV) risk factors and relationships between IMT, CV risk factors and left ventricular (LV) geometric remodelling. 198 asymptomatic, never treated, essential hypertensives (age: 58.2 +/- 13) and 67 (age-gender matched) healthy subjects, were studied. Complete clinical examination, 2D Doppler echocardiography and vascular echography were performed in all study subjects. Major values of IMT are present in concentric LVH. Distribution of IMT among risk factors groups shows an higher IMT respect to increasing number of risk factors (P < 0.001). Significant correlation are present between pulse pressure and IMT (P < 0.006; r = 0.19) and IMT and LVM (P < 0.0001; r = 0.35). Altered patterns of LV geometry and carotid structural changes occur in many patients with essential hypertension. LVH or carotid remodeling are greater in elderly, in patients with higher systolic BP and with associated CV risk factors.

ge dependent vascular remodeling in elderly patients with arterial hypertension

“…For instance, paper of di Bello (2009) postulated significant correlation between pulse pressure and IMT, but this data are no doubt questionable, for r value in this work was equal to only 0.19, and no analysis of nonlinear correlation was mentioned. In our study no data sustained possibility of blood pressure level influence upon IMT was received [8]. So, the possible conclusion is that age dependent increase of IMT belongs to involutional process in human arteries.…”

Left ventricular mass-geometry and silent cerebrovascular disease: The Cardiovascular Abnormalities and Brain Lesions (CABL) study

“…Second, LVH, especially concentric, is known to be associated with increased carotid artery intima-media thickening. 30, 31 A progressive increase in intima-media thickness was previously described, from the lowest values in patients with normal geometry (0.68mm) to intermediate in those with concentric remodeling (0.76mm) and eccentric hypertrophy (0.81mm) and to the highest level in patients with concentric hypertrophy (0.87mm) in 1074 hypertensive patients. 30 Because carotid artery disease is an established risk for silent cerebrovascular disease, 32 its association with LVH might be involved in the explanation of our results.…”

Clinical usefulness of cardio-ankle vascular index, local artery carotid stiffness and global longitudinal strain in subjects with cardiovascular risk factors

“…[4] For all these reasons, efforts are increasingly being targeted toward early diagnosis for intervening at an earlier stage of disease. Italian Society of Echocardiography has been involved from its origins in preventive field, developing several research programs,[4567891011121314] including Disfunzione Asintomatica VEntricolare Sinistra[15] study (on cardiac field), and considering deeply prognostic implications of vascular disease.…”

“…Risk assessment using carotid ultrasound focuses on the measurement of the intima-media thickness (IMT) and the presence of plaques and their characteristics. [7]…”

“…Nevertheless, the predictive value is relatively small compared with the finding of a stenosis and the technique requires careful training and standardization. [7814]…”