INTEREST OF MEASURING THE INTIMA MEDIA THICKNESS IN THE EVALUATION OF HYPERTENSIVE

Abstract

Objective: The measurement of the Intima Media Thickness (IMT) allows the diagnosis of the early stages of atherothrombosis. There is a direct correlation between the intima media thickness and CVRF in particular hypertension. The objective of our study is to describe the profile of IMT in hypertensive patients and to analyze the correlations with subclinical damage to target organs. Design and method: Descriptive and analytical prospective study of a cohort of asymptomatic hypertensive patients aged over 35 received in consultation. All the patients had benefited from a measurement of the intima media thickness. An intima-media thickness > 0.9 mm is considered pathological. At the same time, patients benefit from a systematic assessment in search of other target organ damage, namely cardiac, neurological, renal and ophthalmological damage. Results: 252 patients included in our work, it is 146 women or 58%. The average age of our series is 59.5 years. The EIM is pathological in 34.9% of patients. In multivariate analysis, the two independent factors associated with pathological ADR are age > 55 years and smoking. Chi-square correlation analysis shows us a highly significant correlation between pathological IMT and LVH on ultrasound, carotid plaques and stenosing plaques, and urinary albumin excretion and kidney disease chronic. Intima Media thickness values are positively correlated with indexed left ventricular mass values (pearson 0.190**, p = 0.004), pulse pressure values (pearson = 0.226**[0.123, 0.344] p = 0.000), to the values of the Sokolow index (0.145*[0.032, 0.261] p = 0.029) and to the values of proteinuria and particularly to microalbuminuria (0.187**[0.013, 0.369] p = 0.008) The values of the media intima thickness are negatively correlated with MDRD clearance values (-0.140* [-0.250, -0.019] p = 0.037) Conclusions: Carotid intima media thickness is an excellent screening test for target organ damage in hypertensive patients. It is a simple and non-invasive measure, it reflects early lesions of atherosclerosis. Our study clearly shows the strong correlation between the values of the intima media thickness and the values of all the screening tests for target organ damage.