Incidence Of Carotid Plaque Research Articles

Relationship of carotid artery intima media thickness to blood pressure, age and body mass index of hypertensive adult patients

Background: The intima-media thickness (IMT) has been established as an early predictor of general arteriosclerosis in patients with hypertension. The aims of this study were to establish the relationship between carotid IMT (CIMT) and blood pressure of hypertensive adult patients and to correlate CIMT with age and body mass index (BMI) in hypertensive adult patients. Patients and Methods: This prospective study was carried out from November 2012 to February 2013 on 200 hypertensive patients aged 21-70 years. The common carotid artery (CCA) was scanned using an ALOKA SSD-3500 ultrasound scanner with Doppler facility and a 7.5MHz linear transducer. Three measurements of the CIMT were obtained at 1cm proximal to the right and left carotid bulb and the mean value of the three measurements was recorded. Results: There were 200 patients comprising 67 males and 133 females. Their ages ranged 21-70 years, mean of 50.62 ± 10.46 years. The right and left mean CIMT was 0.99 ± 0.13 and 0.99 ± 0.18, respectively; while the overall mean CIMT for both sides was 0.99 mm ± 0.13. The mean BMI for the studied group was 29.09 ± 5.68. The mean systolic and diastolic blood pressure (SBP and DBP) was 157.0 ± 15.5 and 97.6 ± 11.2 mmHg, respectively. There was a significant difference in the mean CIMT value for each SBP and DBP groupings. CIMT correlated positively with age and blood pressure, but had a negative correlation with BMI. Carotid plaques were seen in the CCA wall of 20 patients (10%). Conclusion: In hypertensives, age and blood pressureare the most important determinants of CIMT. The incidence of carotid plagues in our patients was high; therefore, good control of blood pressure in hypertensives may reduce the incidence of carotid plaques and stroke.

Five-year change in systolic blood pressure is independently associated with carotid atherosclerosis progression: a population-based cohort study.

The aim of this study was to investigate whether long-term changes in traditional risk factors affect the progression of carotid atherosclerosis in a Chinese population. This study included 1590 individuals (aged 56.9±8.1 years) with no evidence of carotid plaque at baseline (2002). In 2007, these individuals completed the second risk factors survey and underwent carotid plaque measurement. The incidence of carotid plaque and the total plaque area of maximum plaques (TPA) were used to evaluate the progression of carotid atherosclerosis. In addition to baseline age, systolic blood pressure (SBP), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglyceride (TG), common carotid intima-media thickness (CIMT) and current smoking, a 5-year change in SBP was also associated with the incidence of carotid plaque (odds ratio=1.01, 95% confidence interval: 1.01-1.02, P=0.029). Furthermore, multiple linear regression analysis revealed that a 5-year change in SBP had a linear association with TPA after adjusting for baseline risk factors (standardized regression coefficient=0.071, P=0.014). TPA increased both by increasing baseline SBP and by a 5-year SBP change when adjusted for sex, baseline age, TC, HDL-C, CIMT and current smoking (P for trend <0.001 and 0.004). Our study demonstrates that a 5-year change in SBP is independently associated with the progression of carotid atherosclerosis in the Chinese population. These findings underline the importance of early detection and control of SBP for the prevention of atherosclerosis progression. The progression of atherosclerosis is not only associated with hypertension but can also progress silently with the development of SBP.

25-Hydroxyvitamin D and Parathyroid Hormone Are Not Associated With Carotid Intima-Media Thickness or Plaque in the Multi-Ethnic Study of Atherosclerosis

Observational evidence supports independent associations of 25-hydroxyvitamin D (25-OHD) and parathyroid hormone (PTH) with cardiovascular risk. A plausible hypothesis for these associations is accelerated development of atherosclerosis. We evaluated cross-sectional and longitudinal associations of 25-OHD and PTH with carotid intima-media thickness (IMT) and carotid plaques among 3251 participants free of cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis. 25-OHD and PTH were measured at baseline by mass spectrometry and immunoassay, respectively. All subjects underwent a carotid ultrasound examination at baseline and 9.4 years later (median, range 8-11.1 years). Multivariable linear and logistic regressions were used to test associations of 25-OHD and PTH with the extent and progression of IMT and the prevalence and incidence of carotid plaque. Mean (SD) 25-OHD and PTH were 25.8 ng/mL (10.6) and 44.2 pg/mL (20.2), respectively. No independent associations were found between 25-OHD or PTH and IMT at baseline (increment of 1.9 μm [95% confidence interval, -5.1 to 8.9] per 10 ng/mL lower 25-OHD; increment of 0.8 μm [95% confidence interval, -3.2 to 4.8] per 10 pg/mL higher PTH) or progression of IMT (increment of 2.6 μm [95% confidence interval, -2.5 to 7.8] per 10 ng/mL lower 25-OHD, increment of 1.6 μm [95% confidence interval, -1.9 to 5.2] per 10 pg/mL higher PTH). No associations were found with the baseline prevalence of carotid plaque or the incidence of new plaques during the study period. We did not observe any interaction by race or ethnicity (White, Chinese, Black, and Hispanic). The consistent lack of association of vitamin D and PTH with carotid IMT and plaque suggests that these hormones may influence cardiovascular risk through pathways not reflected by carotid atherosclerosis.

P-222 Association Between Hyperuricemia and Incidence of Carotid Plaque

P-222 Association Between Hyperuricemia and Incidence of Carotid Plaque

P-225 Prevalence and Pattern of Hypertension Among Young Pakistani Asians; An Observational Study Exploring the Hidden Bitter Truths

Results: (1) The standard prevalence of hyperuricemia on baseline was 5.4%, 7.7% in male and 3.9% in female. (2) The standard incidence of carotid plaque was 45.3%, 51.7% in male was 42.7% in female. It was showed that the incidence of plaque in bulb of common carotid arteries was the highest. (3) After adjusting for age, smoking, high triglyceride, high cholesterol, hypertension, diabetes, overweight and obesity, hyperuricemia in female was an independent risk factor associated with 5-year incident plaque in bulb of common carotid, the Odds Ratio (OR) was 3.56 (P= 0.02, 95%CI: 1.21, 10.41). Conclusions: Hyperuricemia in female was an independent risk factor associated with 5-year incident plaque in bulb of common carotid, and hyperuricemia in male was not an independent factor associated with 5-year incident plaque.

Closed Relation Between Carotid and Ascending Aortic Atherosclerosis in Cardiac Patients

Background —Carotid atherosclerosis and aortic atherosclerosis are both associated with coronary artery disease and cerebral thromboembolism. However, the relationship between asymptomatic carotid and aortic atherosclerosis is not well known. Methods and Results —Sixty-two consecutive cardiac patients (mean age 57 years) without a history of atherosclerotic cardiovascular disease who were referred for transesophageal echocardiography were included. By means of a high-resolution ultrasound technique, normal carotid arteries were found in 12 patients (19.4%), whereas 15 patients (24.2%) had increased intima-media thickness, and the remaining 35 patients (56.5%) had atherosclerotic plaques (intima-media thickness ≥1.3 mm). Transesophageal echocardiography characterized ascending aortic intimal morphology as normal in 1 patient (1.6%), as thickening in 22 patients (35.5%), and as atherosclerotic plaques in 39 patients (62.9%). Patients with both carotid and aortic plaques were older compared with patients without plaques; also, a higher percentage of patients with carotid and aortic plaques suffered from hypertension and diabetes mellitus compared with patients without plaques ( P &lt;0.001). The incidence of carotid plaques was 74.3% (29 of 39 patients) in the subgroup with aortic plaques; there was a stepwise increase in the percentage of patients with carotid plaques among the patients with increasing grades of aortic atherosclerosis. Furthermore, the incidence of ascending aortic plaques was 82.8% (29 of 35 patients) in the subgroup with carotid plaques. Regression analysis revealed that age and carotid plaques were independently related to the presence of aortic plaques. In the entire study population, the presence of carotid plaques had a high positive predictive value (83%), an acceptable sensitivity (75%) and specificity (74%), and a relatively low negative predictive value (63%) for the presence of aortic plaques. Conclusions —In cardiac patients without clinical evidence of atherosclerotic cardiovascular disease, a high prevalence of combined aortic and carotid plaques were detected. The presence of carotid plaque reflects the presence of aortic plaque, whereas the absence of carotid plaque may not reflect the absence of aortic plaque.