Kidney function and thickness of carotid intima‐media complex in patients with treated arterial hypertension

Abstract

The aim of the study was to evaluate of the association between renal function and the intima‐media thickness of common carotid artery (CCA‐IMT) in treated hypertensive patients. Eighty‐seven hypertensives (51.7% diabetic), aged >45 years, were examined. Renal function was evaluated by plasma concentration of creatinine, cystatin C (in 64 patients) and creatinine clearance, calculated according to the Cockcroft–Gault formula. HbA1c measurement and blood pressure monitoring were performed. CCA‐IMT was measured at near and far wall of the CCA and of the bulb on both sides and averaged. In 63 hypertensives (72.4%) IMT was over 0.9 mm. These subjects were older (71.17±9.72 vs 57.75±7.76 years; p<0.0001), had higher pulse pressure (57.45±11.73 vs 49.35±8.35, p = 0.004), cystatin C concentration (1.25±0.34 vs 0.99±0.17 mg/l; p = 0.002), higher HbA1c (7.24±1.59 vs 6.25±1.28, p = 0.01), and lower creatinine clearance (71.28±28.32 vs 93.86±25.04; p<0.0001) in comparison to patients with IMT <0.9 mm. Groups did not differ with respect to creatinine concentration. The logistic regression analysis showed that CCA‐IMT was independently influenced only by age, and the effect of age was stronger in older patients. After exclusion of age, 0.1 mg/l higher concentrations of cystatin C or 10 ml/min lower estimated creatinine clearance were significantly associated with 56% and 34%, respectively, higher probability of CCA‐IMT of more than 0.9 mm. Cystatin C concentration seems to be a useful indicator of renal function impairment associated with carotid intima‐media thickening. Similar information is obtained when estimated creatinine clearance is used.