Key result
Isolated hypertension was significantly associated with a higher prevalence of increased common carotid artery intima media thickness compared to healthy controls (37% vs 12%, p=0.001).
Why the study?
The prevalence of atherosclerosis in extracranial vessels among hypertensive patients in southern Egypt was unknown.
Does isolated hypertension increase the prevalence of asymptomatic extracranial atherosclerosis compared to healthy controls?
Case-Control (n=200)
No
Does isolated hypertension increase the prevalence of asymptomatic extracranial atherosclerosis compared to healthy controls?
Absolute Event Rate: 37% vs 12%
p-value: p=0.001
Uncontrolled hypertension is strongly associated with increased carotid intima-media thickness and asymptomatic carotid stenosis in patients without other cardiovascular risk factors.
Supports screening for asymptomatic carotid disease in isolated hypertension; leaves open whether early detection in.
OBJECTIVE: The prevalence of atherosclerosis in extracranial vessels among hypertensive patients in southern Egypt is still unknown. Carotid ultrasound is an accurate method used to identify and follow patients with cerebrovascular disorders. The aim of our study is to detect the prevalence and pattern of extracranial atherosclerosis among those patients. METHODS: Our case-control study was performed from January 2017 to January 2018, including 200 subjects, 100 patients recruited consecutively from the Hypertension Clinic in Assiut University hospitals, Egypt, and 100 healthy controls. Detailed history collection and thorough physical examinations were carried out for each patient. All subjects underwent extracranial ultrasound. We omitted patients with history of ischemic stroke and TIAs. RESULTS: The presence of increased intima media thickness was detected in 37 patients (37%). 22 patients (22%) had internal carotid artery (ICA) stenosis, 17 patients (17%) had non-significant stenosis <50%, while five patients (5%) had stenosis 50-69%. 9% had stenosis < 50% in vertebral artery. In addition, age and uncontrolled hypertension have a greater impact on increasing the CCA intima media thickness, which is considered an early sign of atherosclerosis. CONCLUSION: Uncontrolled hypertension is an important risk factor for atherosclerosis and hence ischemic stroke (IS). The cost of screening is considered low compared to IS management. Greater emphasis should be directed toward regular screening programs in this risky population.
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Shehata et al. (2020) conducted a case-control in Hypertension (n=200). Hypertension vs. Healthy controls was evaluated on Abnormal common carotid artery intima media thickness (>0.1 cm) (p=0.001). Isolated hypertension was significantly associated with a higher prevalence of increased common carotid artery intima media thickness compared to healthy controls (37% vs 12%, p=0.001).
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