| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
© 1999 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Factors Underlying the Increase in Carotid Intima-Media Thickness in Borderline Hypertensives
From the Dipartimento di Medicina Clinica e Sperimentale, Clinica Medica IV, Università degli Studi di Padova, Italy.
Correspondence to Dr Paolo Pauletto, Dipartimento di Medicina Clinica e Sperimentale, Università di Padova, Via Giustiniani 2, 35128 Padova, Italy. E-mail pauletto{at}ux1.unipd.it OR Dr Santica M. Marcovina, University of Washington, Northwest Lipid Research Laboratories, 2121 N 35th Street, Seattle, Washington 98103.
Abstract—To define the role played by various risk and behavioral factors in the increase of carotid intima-media thickness (IMT) observed in borderline hypertensives. Using B-mode ultrasonography, we compared 97 borderline hypertensives enrolled in the HARVEST study to 27 normotensive controls. Intima-media thickness was measured in the right and left common carotid artery, bulb, and internal carotid artery. Mean IMT (m-IMT), maximum IMT (M-IMT), the mean of M-IMT (M-MAX), and the prevalence of raised lesions (IMT>1 mm) were established. Compared to the controls, higher systolic BP, diastolic BP, mean arterial blood pressure levels and body mass index (BMI) were present in the borderline hypertensives, whereas age, smoking, physical activity, serum cholesterol, and triglycerides were similar. After adjusting for age, sex, heart rate, BMI, smoking, serum cholesterol, triglycerides, and physical activity, higher values of m-IMT and M-IMT were present in most carotid segments of borderline hypertensives compared with controls. After further adjustment for systolic BP and diastolic BP, differences were no longer significant. The adjusted M-MAX was 0.59±0.12 in borderline hypertensives compared with 0.50±0.10 in controls (P<0.001). After adjustment for systolic BP and diastolic BP it was 0.58±0.11 in borderline hypertensives compared with 0.50±0.12 in controls (P<0.005). In the various carotid segments, the prevalence of raised lesions was 1.2% in borderline hypertensives compared with 0.3% in controls (P<0.001). In the multivariate analysis m-IMT, M-IMT, and M-MAX were related to ambulatory mean arterial pressure, systolic BP and diastolic BP, serum cholesterol and triglycerides, BMI, age, and physical activity. Higher IMT values were found in subjects who were physically active than in those who were sedentary. In borderline hypertensives, an increase in IMT takes place not only in the common carotid artery but also in the bulb and the internal carotid segment. Blood pressure levels are a main determinant of m-IMT while the interaction of BP with other risk factors such as age and plasma lipids is more relevant for advanced intima-media thickening such as M-MAX.
Key Words: intimal-medial thickness • carotid • borderline hypertension • risk factors
This article has been cited by other articles:
 |
|
 |
|
  E. Manios, G. Tsivgoulis, E. Koroboki, K. Stamatelopoulos, C. Papamichael, S. Toumanidis, E. Stamboulis, K. Vemmos, and N. Zakopoulos Impact of Prehypertension on Common Carotid Artery Intima-Media Thickness and Left Ventricular Mass Stroke, April 1, 2009; 40(4): 1515 - 1518. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. A. Calo, M. Puato, S. Schiavo, M. Zanardo, C. Tirrito, E. Pagnin, G. Balbi, P. A. Davis, P. Palatini, and P. Pauletto Absence of vascular remodelling in a high angiotensin-II state (Bartter's and Gitelman's syndromes): implications for angiotensin II signalling pathways Nephrol. Dial. Transplant., September 1, 2008; 23(9): 2804 - 2809. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. Puato, P. Palatini, M. Zanardo, F. Dorigatti, C. Tirrito, M. Rattazzi, and P. Pauletto Increase in Carotid Intima-Media Thickness in Grade I Hypertensive Subjects: White-Coat Versus Sustained Hypertension Hypertension, May 1, 2008; 51(5): 1300 - 1305. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. Femia, M. Kozakova, M. Nannipieri, C. Gonzales-Villalpando, M. P. Stern, S. M. Haffner, and E. Ferrannini Carotid Intima-Media Thickness in Confirmed Prehypertensive Subjects: Predictors and Progression Arterioscler Thromb Vasc Biol, October 1, 2007; 27(10): 2244 - 2249. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. N. Kiortsis, S. Tsouli, E. S. Lourida, V. Xydis, M. I. Argyropoulou, M. Elisaf, and A. D. Tselepis Lack of Association Between Carotid Intima-Media Thickness and PAF-Acetylhydrolase Mass and Activity in Patients with Primary Hyperlipidemia Angiology, July 1, 2005; 56(4): 451 - 458. [Abstract] [PDF]
|
|
|
|
 |
|
 A. Vryonidou, A. Papatheodorou, A. Tavridou, T. Terzi, V. Loi, I.-A. Vatalas, N. Batakis, C. Phenekos, and A. Dionyssiou-Asteriou Association of Hyperandrogenemic and Metabolic Phenotype with Carotid Intima-Media Thickness in Young Women with Polycystic Ovary Syndrome J. Clin. Endocrinol. Metab., May 1, 2005; 90(5): 2740 - 2746. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Poredos Intima-media thickness: indicator of cardiovascular risk and measure of the extent of atherosclerosis Vascular Medicine, February 1, 2004; 9(1): 46 - 54. [Abstract] [PDF]
|
|
|
|
 |
|
 A Doria, Y Shoenfeld, R Wu, P F Gambari, M Puato, A Ghirardello, B Gilburd, S Corbanese, M Patnaik, S Zampieri, et al. Risk factors for subclinical atherosclerosis in a prospective cohort of patients with systemic lupus erythematosus Ann Rheum Dis, November 1, 2003; 62(11): 1071 - 1077. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. A. R. Hernandez, A. A. Kroon, M. P.J. van Boxtel, W. H. Mess, J. Lodder, J. Jolles, and P. W. de Leeuw Is There a Side Predilection for Cerebrovascular Disease? Hypertension, July 1, 2003; 42(1): 56 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. W. Myers, W. B. Farquhar, D. E. Forman, T. D. Williams, D. L. Dierks, and J. A. Taylor Carotid distensibility characterized via the isometric exercise pressor response Am J Physiol Heart Circ Physiol, December 1, 2002; 283(6): H2592 - H2598. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. J. Gianaros, M. E. Bleil, M. F. Muldoon, J.R. Jennings, K. Sutton-Tyrrell, J. M. McCaffery, and S. B. Manuck Is Cardiovascular Reactivity Associated With Atherosclerosis Among Hypertensives? Hypertension, November 1, 2002; 40(5): 742 - 747. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K.-S. Cheng, D. P. Mikhailidis, G. Hamilton, and A. M. Seifalian A review of the carotid and femoral intima-media thickness as an indicator of the presence of peripheral vascular disease and cardiovascular risk factors Cardiovasc Res, June 1, 2002; 54(3): 528 - 538. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. H. Davis, J. D. Dawson, W. A. Riley, and R. M. Lauer Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age: The Muscatine Study Circulation, December 4, 2001; 104(23): 2815 - 2819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T.-C. Su, J.-S. Jeng, K.-L. Chien, F.-C. Sung, H.-C. Hsu, and Y.-T. Lee Hypertension Status Is the Major Determinant of Carotid Atherosclerosis: A Community-Based Study in Taiwan Stroke, October 1, 2001; 32(10): 2265 - 2271. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Pauletto, M. Puato, E. Faggin, N. Santipolo, V. Pagliara, M. Zoleo, G. P. Deriu, F. Grego, M. Plebani, S. Sartore, et al. Specific Cellular Features of Atheroma Associated With Development of Neointima After Carotid Endarterectomy : The Carotid Atherosclerosis and Restenosis Study Circulation, August 15, 2000; 102(7): 771 - 778. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Ueno, P. Kanellakis, A. Agrotis, and A. Bobik Blood Flow Regulates the Development of Vascular Hypertrophy, Smooth Muscle Cell Proliferation, and Endothelial Cell Nitric Oxide Synthase in Hypertension Hypertension, July 1, 2000; 36(1): 89 - 96. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Tanaka, D. R. Seals, K. D. Monahan, C. M. Clevenger, C. A. DeSouza, and F. A. Dinenno Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men J Appl Physiol, April 1, 2002; 92(4): 1458 - 1464. [Abstract] [Full Text] [PDF]
|
|