Dependence of carotid arteries intima-media thickness on body weight of patients with hypertension

Abstract

The aim was to study the dependence of structural changes in the common carotid arteries (intima-media complex thickness and vascular diameter) on the body weight index of hypertensive patients. Material and methods. The study included 84 patients with stage 2 essential hypertension (EH) and 15 healthy people. Groups did not differ significantly in age, gender, height. Patients with EH, depending on the body mass index, were divided into three groups: normal body weight (n = 19), overweight (n = 34) and obesity (n = 31). The study excludes patients with intima-media complex thickness (IMT) of more than 900 μm or atherosclerotic plaques presence in the common carotid arteries (CCA). All patients were measured: office ABP, diameter and intima-media complex thickness of the common carotid arteries, structural-geometric and functional indicators of the heart. Results. In patients with EH there is a simultaneous remodeling of blood vessels (a significant increase in IMT of 17,8% and CCA diameter of 6,6%) and the heart (LV hypertrophy, left atrium dilation,LV end diastolic pressure increase). Hypertensive patients with overweight and obesity had significantly higher right CCA diameters by 8.1% (p = 0.016) and 6.9% (p = 0.039), respectively, than those with EH and normal body mass. The left CCA diameter was significantly higher by 8.7% (p = 0.012) in patients with overweight compared to a similar figure in patients with EH and normal body mass. Patients with normal, overweight and obesity with EH significantly did not differ according to the indicators of CCA IMT on both sides. With an increase in the body mass index in patients with EH there is a progressive increase in the left atrium diastolic size: in patients with overweight by 10.7% (p = 0.005) more than in normal body weight patients; and with obesity by 2,5% (p = 0,001) more than in overweight patients. In patients with EH and obesity the right CCA IMT correlated with age (r = 0.41; p = 0.02), EF LV (r = 0.39; p = 0.03), theLV posterior wall thickness (r = 0.37; p = 0.04), E / E '(r = 0.39; p = 0.04). In patients with EH and normal body mass the right CCA IMT correlated with the left atrium diastolic size (r = 0.51; p = 0.02), body weight (r = 0.57; p = 0.01); the left CCA IMT with body weight (r = 0.48; p = 0.04); body mass index (r = 0.61; p = 0.01) and aorta diameter (r = 0.51; p = 0; 02). In patients with EH and obesity the intima-media complex minimum thickness (604 ± 31 μm) occurred in the normal type ofLV geometry and significantly (p = 0.023) increased by almost 100 μm in eccentric hypertrophy and amounted to 703 ± 93 μm. Conclusions . An increase in the body mass index in patients with EH is accompanied by an increase in the common carotid arteries diameter, the left atrium diastolic size, the posterior wall thickness and the left ventricular mass index. In patients with EH and normal body mass the right CCA IMT correlated with body weight (r = 0.57; p = 0.01); the left CCA IMT with body weight (r = 0.48; p = 0.04) and BMI (r = 0.61; p = 0.01). A significant increase in the intima-media complex thickness of the left CCA occurs only among obese patients with eccentric hypertrophy compared with normal left ventricular geometry.