Influence of age, body mass index, and blood pressure on the carotid intima-media thickness in normotensive and hypertensive patients

Abstract

We investigated whether body mass index and blood pressure have an additive influence on the carotid intima-media thickness (IMT). In 27 patients treated for hypertension (47.2+/-8.7 years) and 23 normotensive subjects (44.1+/-8.1 years), 24-h recording of blood pressure was performed. The carotid IMT was determined by ultrasonography and baroreflex sensitivity by a spectral method from 5-min recordings of blood pressure. Significant differences between hypertensive and normotensive subjects were observed for carotid IMT (0.60+/-0.08 vs. 0.51+/-0.07 mm; p<0.001) and baroreflex sensitivity (3.5+/-1.8 vs. 5.6+/-2.1 ms/mm Hg; p<0.001). Hierarchical multiple regression analysis (p<0.01) showed that carotid IMT was positively correlated with age (p<0.001) and body mass index (p<0.05) in normotensive subjects. The increased carotid IMT in hypertensive patients was not additively influenced by either age or body mass index. Baroreflex sensitivity decreased with age (p<0.01) and with carotid IMT (p<0.05) in normotensive subjects only. Multiregression analysis showed that an additive influence of age and body mass index on the development of carotid IMT is essential only in normotensive subjects. In hypertensive subjects the influence of blood pressure predominates, as documented by a comparison of the carotid IMT between hypertensive and normotensive subjects.

Impaired autonomic function in normotensive obese children

“…This was in agreement with the observations made in adults, animals [19][20][21] and children [22]. One factor that could be responsible for this lower level of BRS is increased thickness of carotid wall [23]. We attempted to study vascular stiffness in these children, using applanation tonometry, of the carotid artery.…”

Baroreflex sensitivity is reduced in obese normotensive children and adolescents

“…Different factors influence baroreflex sensitivity in the normal population, including sex, age, level of physical activity, mean BP, heart rate, body mass index (BMI), mechanical properties of arteries, and plasma levels of glucose and insulin (Parati et al 1988;Laederach-Hofmann et al 2000;Kardos et al 2001;Honzíková et al 2006a). In adults, decreased baroreflex sensitivity was found in various pathological conditions, including diabetes mellitus (Frattola et al 1997;Lefrandt et al 1999), hypertension (Gribbin et al 1971;Lábrová et al 2005) and obesity (Grassi et al 1995;Alvarez et al 2005).…”

“…In adults, decreased baroreflex sensitivity was found in various pathological conditions, including diabetes mellitus (Frattola et al 1997;Lefrandt et al 1999), hypertension (Gribbin et al 1971;Lábrová et al 2005) and obesity (Grassi et al 1995;Alvarez et al 2005). The decrease in baroreflex sensitivity may be caused by autonomic nervous system (ANS) dysfunction (Spraul et al 1994;Chapleau et al 1995;Miller et al 1999), and (or) by changes in the mechanical properties of the arterial wall (Tanaka et al 2001;Honzíková et al 2006a).…”

Is Low Baroreflex Sensitivity only a Consequence of Essential Hypertension or also a Factor Conditioning Its Development?

“…The association between BRS and intima-media thickness (IMT) in the carotid bulb, a region with high baroreceptor density, was shown as a marker of subclinical atherosclerosis and essential hypertension (Gianaros et al, 2002;Honzikova et al, 2006a;Labrova et al, 2005;Zanchetti et al 1998). Carotid IMT also correlated with age in people who were not hypertensives (Labrova et al, 2005).…”