Factors influencing hemodynamic and morphological indicators of carotid arteries atherosclerosis in treated hypertensive patients

Abstract

Objectives: To evaluate factors influencing resistive index (RI) and intima-media thickness of common carotid artery (IMT-CCA) as indices of arterial atherosclerosis in hypertensive patients. Methods: 56 treated hypertensive outpatients (mean age 68.9 ± 9.7 years; 31 diabetics) were examined. Fasting blood glucose, cholesterol, and HbA1c concentration and glomerular filtration rate were measured. Systolic (SBP), diastolic blood pressure (DBP) and pulse pressure were estimated during ambulatory blood pressure monitoring. Ultrasonography of the CCA was performed with determination of IMT-CCA and RI. Results: With diabetes IMT-CCA was significantly (1.025 ± 0.17 vs 0.928 ± 0.18 mm, p = 0.04) and RI not significantly (0.71 ± 0.06 vs 0.68 ± 0.08, p = 0.07) higher. A correlation between HbA1c and RI, IMT-CCA and the age was found. After dividing the whole group into subgroups corresponding to the tertiles of HbA1c levels, mean IMT-CCA values in I and II tertile were significantly lower than in III tertile (p = 0.008 and p = 0.002 respectively), while RI was significantly higher in III tertile than in I tertile (p = 0.03). On multiple regression analysis IMT-CCA was significantly influenced by the age (β = 0.343, p = 0.04), SBP (β = 0.430, p = 0.03) and HbA1c (β = 0.369, p = 0.01), while RI was influenced by SBP (β = 0.696, p = 0.0006), DBP (β = −0.618, p = 0.003) and HbA1c (β = 0.279, p = 0.04). Conclusion: Patients with hypertension and diabetes mellitus had significantly increased IMT and not significantly higher RI. Concentration of HbA1c, next to the age, SBP and DBP values was independently associated with IMT-CCA and RI – parameters determining indirectly the degree of atherosclerosis of common carotid artery.

Keywords

• Intima-media thickness
• Resistive index
• Arterial hypertension
• Carotid atherosclerosis