Hypertension significantly increased the risk of carotid atherosclerosis compared with normotensive subjects, including maximal IMT ≥75th percentile (OR 5.0; 95% CI 3.0-8.4).
Cross-Sectional (n=533)
Does hypertension status increase the risk of extracranial carotid artery atherosclerosis in adults?
Hypertension is a major determinant of carotid atherosclerosis severity, significantly increasing the risk of increased intima-media thickness, plaque burden, and stenosis.
Odds Ratio: 5 (95% CI 3–8.4)
BACKGROUND AND PURPOSE: Extracranial carotid artery (ECCA) atherosclerosis has been associated with hypertension-related stroke. The present study was aimed at investigating the determinants of ECCA atherosclerosis in patients with hypertension in Taiwan. METHODS: The extent and severity of ECCA atherosclerosis were measured by high-resolution B-mode ultrasonography and expressed as maximal intima-media thickness (IMT) of the common carotid artery, ECCA plaque score, and carotid stenosis >/=50%. From July through December 1996, 263 hypertensive patients (146 with hypertension and 117 with borderline hypertension) and 270 normotensive adults from the Chin-Shan Community Cardiovascular Cohort participated in this study. Risk factors and ECCA atherosclerosis were stratified by the blood pressure status. RESULTS: A significant dose-response relationship was found between the status of hypertension and the severity of carotid atherosclerosis. Multivariate logistic regression models revealed that hypertension (including borderline), male gender, smoking, and age >/=65 years significantly increased the risk of thicker IMT. The risk of ECCA plaque score >6 increased significantly in conjunction with hypertension, age >/=65 years, left ventricular hypertrophy on ECG, and smoking. However, hypertension and smoking were the 2 evident determinants of carotid stenosis >/=50% after adjustment for other covariates. Compared with the normotensive subjects, the ORs (and 95% CIs) for the hypertensive patients to develop carotid atherosclerosis were 5.0 (3.0 to 8.4) indexed by maximal common carotid artery IMT >/=75th percentile, 3.7 (1.8 to 7.9) by ECCA score >6, and 4.8 (1.4 to 16.5) by carotid stenosis >/=50%. CONCLUSIONS: Hypertension strongly influence carotid atherosclerosis. Our findings reinforce the hypothesis that hypertension has a major role in the pathogenesis of atherosclerosis.
Su et al. (2001) conducted a cross-sectional in Hypertension and Carotid Atherosclerosis (n=533). Hypertension vs. Normotensive subjects was evaluated on Carotid atherosclerosis indexed by maximal common carotid artery IMT ≥75th percentile (OR 5.0, 95% CI 3.0 to 8.4). Hypertension significantly increased the risk of carotid atherosclerosis compared with normotensive subjects, including maximal IMT ≥75th percentile (OR 5.0; 95% CI 3.0-8.4).