The Relationship Between Carotid Artery Structural Abnormality and Stiffness in Patients With Prehypertension

Abstract

Abstract Background To investigate the difference of carotid structural abnormality and stiffness, and the relationship between carotid structural abnormality and stiffness in prehypertensive and normotensive subjects. Methods A total of 581 participants (270 with prehypertension, 311 normotensive control subjects) from the First Affiliated Hospital of Fujian Medical University were enrolled from January 2017 to March 2019. Body height/weight, resting heart rate, and blood pressure were recorded. Blood biochemical indexes and carotid–femoral pulse wave velocity were determined, and carotid ultrasonography was performed. Carotid intima–media thickness ≥1.0 mm and carotid–femoral pulse wave velocity ≥10.0 m/s were defined as carotid structural abnormality and arterial stiffness, respectively. Results The percentage of patients with carotid structural abnormality (60.7% vs. 51.4%), carotid–femoral pulse wave velocity [(8.78 ± 1.48) vs. (7.92 ± 1.30) m/s], and the percentage of patients with arterial stiffness (13.7% vs. 5.8%) were increased in the prehypertension group compared with the control group (all P < 0.05). In the prehypertension group, the percentage of patients with arterial stiffness in the abnormal carotid structure subgroup (n = 164) was higher than that in the normal carotid structure subgroup (n = 106) (20.1% vs. 3.8%, χ2 = 14.551, P < 0.001). Furthermore, carotid structural abnormality, age, diabetes mellitus, resting heart rate, systolic blood pressure, fasting blood glucose, glycosylated hemoglobin A1c, and hypoglycemic therapy were all correlated with arterial stiffness (all P < 0.05). After adjusting for other cardiovascular risk factors, multiple logistic regression analysis showed that carotid structural abnormality, age, diabetes mellitus, and resting heart rate were independently correlated with arterial stiffness, and patients with carotid structural abnormality had 5.25-fold higher risk of arterial stiffness than those with a normal carotid arterial structure (odds ratio = 5.250, 95% confidence interval 1.580–17.448, P = 0.007). However, in the normotensive group, no such relationships were observed between carotid artery structural abnormality and stiffness. Conclusions In prehypertensives but not normotensives, carotid artery structural abnormalities and stiffness are common, and independently correlated.