Recently, intima-media thickness (IMT) of carotid artery has received an increasing attention as risk factor for cardiovascular disease. In fact, it has been reported that IMT increase of carotid arteries is directly associated with an increased risk of myocardial infarction and stroke. The increase of IMT is often found in patients with classical vascular risk factors, but its relationships with them are not fully elucidated. From a series of 119 consecutive hypertensive patients who underwent Ambulatory Blood Pressure Monitoring (ABPM), (78 treated, 41 untreated; 57 men, 62 women, mean age 55 ± 11, mean Body Mass Index (BMI) 25 ± 3), 95 patients without arterial plaque (IMT>1.2mm) were enrolled. All patients were free of cardiovascular, cerebral, renal and metabolic disorders, including diabetes mellitus. 34 patients were mild hypercholesterolemic (<300md/dl), 13 patients regularly smoked more than 10 cig./daily and 4 were former smokers. ABPM was recorded by SpaceLabs 90207 monitor starting at 10 AM, patients being instructed to go to bed at 11 PM and to stand-up at 7 AM. Readings were obtained automatically at 15-min intervals between 7 AM and 11 PM and at 20-min intervals between 11 PM and 7 AM. Within 1 week from ABPM, patients underwent Duplex scanning of neck vessels. IMT was measured at the last centimetre of the Common Carotid Artery (CCA) before the bifurcation. On each side, IMT was measured at three levels (10mm, 5mm before bifurcation and just before bifurcation) at the anterior and lateral projections, thus obtaining 6 measures on each side. Multiple Regression Analysis was performed with SPSS software; nine variables for blood pressure (mean systolic, diastolic, and pulse pressure (PP) during the day, the night, and over 24 hours, respectively) and one variable for IMT, the mean of 12 measures of both CCA, were considered. IMT was significantly related to age (<.00005) and to PP of 24-hours (<.0005). Our data showed that, in a group of hypertensive patients without arterial plaque and associated clinical conditions, the best predictors for carotid thickening were age and PP of 24 hours in this order.
P-301: Common carotid wall thickening and ambulatory blood pressure monitoring in hypertensive patients
NOBILI, FLAVIO MARIANO;GROSSO, DANIELE;LOTTI, GAETANO;
2001-01-01
Abstract
Recently, intima-media thickness (IMT) of carotid artery has received an increasing attention as risk factor for cardiovascular disease. In fact, it has been reported that IMT increase of carotid arteries is directly associated with an increased risk of myocardial infarction and stroke. The increase of IMT is often found in patients with classical vascular risk factors, but its relationships with them are not fully elucidated. From a series of 119 consecutive hypertensive patients who underwent Ambulatory Blood Pressure Monitoring (ABPM), (78 treated, 41 untreated; 57 men, 62 women, mean age 55 ± 11, mean Body Mass Index (BMI) 25 ± 3), 95 patients without arterial plaque (IMT>1.2mm) were enrolled. All patients were free of cardiovascular, cerebral, renal and metabolic disorders, including diabetes mellitus. 34 patients were mild hypercholesterolemic (<300md/dl), 13 patients regularly smoked more than 10 cig./daily and 4 were former smokers. ABPM was recorded by SpaceLabs 90207 monitor starting at 10 AM, patients being instructed to go to bed at 11 PM and to stand-up at 7 AM. Readings were obtained automatically at 15-min intervals between 7 AM and 11 PM and at 20-min intervals between 11 PM and 7 AM. Within 1 week from ABPM, patients underwent Duplex scanning of neck vessels. IMT was measured at the last centimetre of the Common Carotid Artery (CCA) before the bifurcation. On each side, IMT was measured at three levels (10mm, 5mm before bifurcation and just before bifurcation) at the anterior and lateral projections, thus obtaining 6 measures on each side. Multiple Regression Analysis was performed with SPSS software; nine variables for blood pressure (mean systolic, diastolic, and pulse pressure (PP) during the day, the night, and over 24 hours, respectively) and one variable for IMT, the mean of 12 measures of both CCA, were considered. IMT was significantly related to age (<.00005) and to PP of 24-hours (<.0005). Our data showed that, in a group of hypertensive patients without arterial plaque and associated clinical conditions, the best predictors for carotid thickening were age and PP of 24 hours in this order.
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