RELATIONSHIP BETWEEN CAROTID INTIMA MEDIA THICKNESS AND PHENOTYPES OF HIGH BLOOD PRESSURE IN ADOLESCENTS

Abstract

Objective: The aim of this study was to investigate the relationship between the Carotid Intima Media Thickness (cIMT) and high blood pressure phenotypes (HBPP) in a population of Hispanic adolescents. Design and method: It was conducted a cross-sectional study in Maracaibo, Venezuela that included 616 adolescents, 289 males and 327 females, selected from high school institutions (age: 13-18 years old). An ultrasonic study was carried out through high resolution B-mode ultrasound examinations for the measurement of the c-IMT. Also, 24-hs ambulatory blood pressure (ABPM) monitoring was performed to obtain ambulatory BP during 24-hs, awake and asleep periods. Demographic (age, gender), anthropometric data [weight, height, hip circumference, waist circumference (WC)] and office BP were recorded. The HBPP included were: true normotension (TN), sustained (SH), white coat (WCH) and masked (MH) hypertension according the new American Heart Association recommendations. Spearman Correlation was used to estimate the association between c-IMT and HBBPP. Results: The mean c-IMT value was 0.42 mm in all adolescents, 0.43 in males and 0.41 in females (p = 0.01). The HBPP prevalence in all adolescents was: 4. % (n = 26) for SH, 21.6 % (n = 133) for MH, 1.0 % (n = 6) for WCH and 73.2 % (n = 451) for TN. Males showed statistically significant high prevalence of MH and SH than female group [(28.4% vs. 15.6% for MH) and (8.3% vs. 0.6%) for SH. The adolescents with SH showed statistically significant higher values than those with TN in c-IMTI values [0.45±0.05 vs. 0.41.2±0.061 mm, p = 0.01]. There were statistically significant associations between c-IMT values with HBPP (Sperman rho = 0.115, p = 0.01). Conclusions: This study showed important associations between c-IMT values and HBPP in adolescents. Also, there is a very high prevalence of MH and SH; this condition appears to be associated with male gender. It should be important to evaluate c-IMT in those adolescents with office or ambulatory high BP values to investigate possible vascular changes induced by hypertension.