Key result
Daytime pulse pressure correlates with left carotid remodeling, while nocturnal diastolic pressure links to the right.
Why the study?
Mechanisms of activation of vascular wall remodelling in patients with arterial hypertension have not been studied in depth and require clarification.
Cross-Sectional (n=381)
Yes
In hypertensive patients, left and right carotid artery remodelling exhibit asymmetry and are driven by different blood pressure parameters, with right carotid remodelling associated with disease severity.
Asymmetric carotid remodeling in hypertension may reflect differential BP effects; leaves open whether sided measurements aid risk stratification.
Background. Mechanisms of activation of the process of vascular wall remodelling in patients affected by arterial hypertension have not been studied in depth and require clarification. Materials and methods. The study included 381 patients with hypertension — 212 men and 169 women of the average age 53.0 (47; 60) years. The structural-functional vessel status was determined by the method of duplex scanning and colour duplex mapping of blood flow with the Logiq 500 MO apparatus (GE, USA). Statistical analyses were made using Microsoft Excel software kit, Statistica for Windows 6.0. Results. The patients with hypertension presented some left-right asymmetry of remodelling extracranial carotid arteries. Unlike the impact of remodelling of the right carotid artery, the most essential effect on the left carotid artery was the impact of daytime pulse arterial pressure and variability of the nocturnal systolic arterial pressure (the strength of impact 25.0 and 13.9%, respectively. The processes of remodelling of the right carotid artery are more sensible to the impact of high values of nocturnal diastolic arterial pressure (the strength of impact 16.4%). The beginning of some brain complication is associated with the significant increase in atherosclerotic affection not only of the left, but also of the right carotid artery. Conclusions. Remarkable remodelling of the right carotid artery is often associated with the severity of the disease and to some extent reflects the severity of the flow of the disease and can be regarded as an additional unfavourable feature.
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Kuzmіnova et al. (2016) conducted a cross-sectional in Essential hypertension (n=381). Clinical and instrumental risk factors (e.g., blood pressure parameters, age, waist circumference) vs. Unexposed/lower risk factor levels was evaluated on Severity of structural remodeling of the left and right carotid arteries (SRlca and SRrca). In patients with essential hypertension, left carotid artery remodeling was most influenced by daytime pulse arterial pressure (25.0% impact strength), while right carotid artery remodeling was more sensitive to nocturnal diastolic arterial pressure (16.4%).
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