Preoperative hypertension is associated with atherosclerotic intraplaque hemorrhage in patients undergoing carotid endarterectomy

Comparing Symptomatic and Asymptomatic Carotid Artery Atherosclerosis in Patients With Bilateral Carotid Vulnerable Plaques Using Magnetic Resonance Imaging

“…A recent study found a significant association between the presence of lipid core >10% of plaque area and IPH in patients with preoperative hypertension. 35 It is likely that well-controlled hypertension is important to reduce the incidence of large LRNC and IPH. There is some anecdotal evidence demonstrating that IPH can be decreased with very intensive lipid-lowering therapy, that is, using high intensity statins.…”

Carotid plaque imaging profiling in subjects with risk factors (diabetes and hypertension)

“…As previously seen, Spagnoli et al (33) evidenced that the presence of numerous mononuclear cells characterized the CAP of hypertensive patients. A recent study by Fassaert et al (95) analyzed 1,684 underwent to carotid endarterectomy, and they found that patients with preoperative hypertension (defined as systolic blood pressure ≥160 mmHg) a statistically significant association between systolic hypertension and presence of calcifications, macrophages, lipid core >10% of plaque area, microvessels and IPH, and increased diastolic blood pressure with macrophages, lipid core and IPH, and all these features are typical of the vulnerable CAP. It is also know that hypertension is associated with increased wall volume as reported by Chien et al (96); in the same article, it is also interesting to underline that patients in therapy with angiotensin converting enzyme inhibitors (a category of drugs commonly used for the treatment of hypertension) is associated with increased thickness of the FC of CAP.…”

“…Presence of numerous mononuclear cells (33) Association between increased systolic blood pressure and presence of calcifications, macrophages, lipid core >10% of plaque area, microvessels and IPH (95) Association between increased diastolic blood pressure and presence of macrophages, lipid core and IPH (96) Increased wall volume (96) Progression of CAP above the bifurcation (97) IPH, intraplaque hemorrhage; CAP, carotid artery plaque.…”

Pre-Operative Plasma Extracellular Vesicle Proteins are Associated with a High Risk of Long Term Secondary Major Cardiovascular Events in Patients Undergoing Carotid Endarterectomy

“…To gain more insight into the potential underlying biological mechanisms between the associated EV proteins and MACE, the associations of these specific EV proteins with vulnerable histological plaque characteristics were investigated by logistic and linear regression analyses. Additional confounders to the abovementioned multivariable model were added based on literature: sex; 24 year of surgery; 25 lipid lowering drug use; 26 hypertension; 27 and anticoagulant drug use (for IPH and microvessels only). 28…”