Key result
Essential hypertension in asymptomatic young subjects was associated with higher carotid-IMT (0.91 vs 51, P<0.01) and lower coronary flow velocity reserve (1.9 vs 3.2, P<0.003) than in controls.
Why the study?
Does increased carotid-IMT correlate with reduced coronary flow reserve and diastolic dysfunction in asymptomatic young hypertensive patients?
Case-Control (n=160)
Does increased carotid-IMT correlate with reduced coronary flow reserve and diastolic dysfunction in asymptomatic young hypertensive patients?
Absolute Event Rate: 0.91% vs 51%
p-value: p=<0.01
Carotid-IMT may serve as a useful surrogate marker for subclinical atherosclerosis, reduced coronary flow reserve, and incipient diastolic dysfunction in asymptomatic young hypertensive patients.
May support IMT as surrogate for early vascular changes in young hypertensives; hypothesis-generating, requires longitudinal validation before clinical use.
BACKGROUND: There is an association between coronary artery disease (CAD) and increased carotid-intima media thickness (IMT), a surrogate index of atherosclerosis. This association is poorly studied in asymptomatic subjects with risk factors of CAD. AIM: To study the relationship between carotid-IMT, coronary flow reserve (CFR) and cardiac function in asymptomatic young hypertensive subjects. METHODS: This study includes 82 asymptomatic young subjects with essential hypertension, and 78 healthy control subjects. Carotid-IMT was assessed with B-mode ultrasonography. Treadmill exercise test, CFR and echo Doppler study were performed for all subjects. RESULTS: Hypertensive group had a significantly higher carotid-IMT (0.91 + 0.13 vs. 51 ± 0.09, P < 0.01), and a significantly lower coronary flow velocity reserve (1.9 ± 0.44 vs. 3.2 ± 0.44, P < 0.003) than in control subjects, especially in those with stress induced myocardial ischemia. Multiple linear regression analyses shows that increased carotid-IMT was related to a reduced CFR (r = -843, P < 0.001) and a lower diastolic function (E/e″, r = -512, P < 0.003) in asymptomatic hypertensives. In addition the carotid-IMT showed a significant correlation with family history of hypertension in these subjects (r = 653, P < 0.002). CONCLUSION: Carotid-IMT increases significantly in asymptomatic young hypertensive patients. It has a relationship with stress-induced myocardial ischemia, decrease CFR and incipient diastolic dysfunction in those patients. It could be considered as an index for subclinical atherosclerosis and diastolic dysfunction in asymptomatic subjects with risk factors for CADs.
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Mahfouz et al. (2011) conducted a case-control in Essential hypertension (n=160). Essential hypertension vs. Healthy controls was evaluated on Carotid-IMT (p=<0.01). Essential hypertension in asymptomatic young subjects was associated with higher carotid-IMT (0.91 vs 51, P<0.01) and lower coronary flow velocity reserve (1.9 vs 3.2, P<0.003) than in controls.
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