Ultrasonic evaluation of hemodynamics and morphology of the major arteries of the neck in patients with essential hypertension associated with hemorrhagic stroke

Abstract

Objective. To determine the structural and hemodynamic characteristics of the major arteries of the neck in patients with essential hypertension (EH) associated with hemorrhagic stroke (HS).Materials and methods. The main group (MG) included 107 people (54.0±9.5 years, 38-77 years old) after HS induced by EH, stage II, 6 months and more previously; the control group (CG) consisted of 104 people (53.7±8.9 years, 39-75 years old). Groups of patients were randomized by the key indicators. The patients in both groups underwent ultrasound examination of large arteries of the neck: diameter, peak systolic blood flow velocity (Vps), maximum end diastolic blood velocity (Ved), Pourcelot resistive index (RI), Gosling’s pulsatility index (PI) of common carotid arteries (CCA), internal carotid arteries (ICA), vertebral arteries (VA) and CCA intima-media thickness (IMT) were measured.Results. The diameters of the CCA on the right (7.08±0.073) mm, on the left (7.11±0.083) mm, ICA on the right (5.4±0.048) mm, ICA on the left (5.55±0.069) mm, VA on the right (3.8±0.048) mm, on the left (3.98±0.047) mm were significantly higher in MG compared with the CG. In the anterior circulation Vps and Ved were significantly lower, and RI and PI were significantly higher (with exception of RI in the CCA and ICA on the left) in MG compared to the respective parameters in the CG. In MG compared with CG, the relative risk of macroscopic changes in the large arteries of the neck was 1.52 (95% CI 1,244-1.867) higher than in CG. In MG compared to CG, the relative risk of atherosclerosis was 2.283 (95% CI 1.808-2.884), the relative risk of atherosclerotic plaque presence was 2.547 (95% CI 1.828-3.550). By the χ2 criterion, a relatively strong relationship was found between HS in case of EH and the presence of atherosclerosis of the major arteries of the neck; average relationship between HS in case of EH and the presence of at least one atherosclerotic plaque (Pearson’s conjugacy coefficient (C)). The confidence level was p<0.001. The Spearman rank correlation coefficient (ρ) between the number of months after HS (from 6-months period) and the length, height of major plaques was 0.72 and 0.56, respectively.Conclusions. Structural and hemodynamic features of the major arteries of the neck in patients with EH associated with HS differ from those in patients with EH without HS. These features are one of the factors in the progression of atherosclerosis of the major arteries of the neck.