Abstract
IntroductionCareful observations of long- and short-term outcomes associated with carotid intima-media thickness (IMT) are relatively limited.MethodsA total of 2,972 patients (male:female = 1,960:1,012; mean age = 62 ± 12 years) who underwent carotid IMT measurements from September 2003 to March 2009 were divided into four groups. Group I (n = 271; mean age, 42 ± 7.8 years) included normotensive younger subjects (males, <45 years and females <55 years), group II (n = 992; mean age, 63 ± 9 years) included normotensive elderly subjects, group III (n = 177; mean age, 46 ± 7.8 years) was hypertensive younger subjects, and group IV (n = 1,532; mean age, 63 ± 10.2 years) was hypertensive elderly subjects. We analyzed the clinical and cardiovascular events in the younger hypertensive subjects based on IMT measurements.ResultsThe baseline characteristics of the subjects showed that carotid IMT increased in the elderly subjects and in patients with hypertension. Poor clinical outcomes, such as all-cause death and major adverse cardiac events, were related with age, not with hypertension. Among the conventional risk factors, age and the highest quartile level of right maximum carotid IMT were related with major adverse events (young: odds ratio [OR], 0.47; 95% confidence interval [CI], 0.25 to 0.9 vs. OR, 1.73; 95% CI, 1.20 to 2.49). The patients in the highest quartile of carotid IMT had worse survival outcomes than those with the lowest IMT (p = 0.03).DiscussionSubjects with hypertension had increased carotid IMT levels. Controlling hypertension and carefully evaluating carotid IMT are important to prevent cardiovascular events even in younger subjects with hypertension.
Highlights
Careful observations of long- and short-term outcomes associated with carotid intima-media thickness (IMT) are relatively limited
IMT values were significantly higher in elderly subjects and those with hypertension (Table 1)
We found that major adverse cerebrovascular events (MACE) was significantly associated with age and right maximum IMT thickness when we compared the carotid IMT values of younger subjects with hypertension with those of elderly subjects with normotension
Summary
Careful observations of long- and short-term outcomes associated with carotid intima-media thickness (IMT) are relatively limited. Measurements of carotid intima-media thickness (IMT) have been used as a surrogate screening test for cardiocerebrovascular disease [1,2]. It is quite important to define the clinical significance of IMT as a screening test in a large cohort study This screening test is imperative, considering the socio-economic significance of cardiovascular events in relatively young subjects with hypertension. Most young subjects with hypertension show early vascular changes because of short exposure, Measuring IMT using ultrasonography is simple and safe, uses no radiation, and is an inexpensive test to indirectly examine the presence of coronary atherosclerosis [3,4]. The aim of this study was to determine the clinical usefulness of measuring carotid IMT in relatively young patients with hypertension
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