Effects of blood pressure lowering with amlodipine or lisinopril on vascular structure of the common carotid artery

2001 ◽  
Vol 101 (5) ◽  
pp. 455-464 ◽  
Author(s):  
Alice V. STANTON ◽  
Jeremy N. CHAPMAN ◽  
Jamil MAYET ◽  
Peter S. SEVER ◽  
Neil R. POULTER ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Enzyme Inhibitor ◽  
Intima Media Thickness ◽  
Treated Group ◽  
Treatment Regimens ◽  
Media Thickness ◽  
Increased Risk ◽  
The Common

Increased intima-media thickness of the common carotid artery predicts increased risk of myocardial infarction and stroke. Preliminary evidence suggests that a decrease in blood pressure (BP) is associated with diminished wall thickness. It is not known if all classes of anti-hypertensive agents have similar protective effects. In this double-blind parallel-group clinical trial, 69 previously untreated patients with hypertension were allocated randomly to 1 year of treatment with either amlodipine (5-10mg daily) or lisinopril (5-20mg daily). Doxazosin and bendrofluazide were added if required to achieve BP control. After 12 months of treatment, clinic BP, ambulatory BP and cardiac mass were reduced similarly by the two treatment regimens. Common carotid artery intima-media thickness decreased by 0.048mm (95% confidence intervals -0.066, -0.031mm) in the amlodipine-treated group, but decreased by only 0.027 mm (-0.046, -0.007mm) in the lisinopril-treated group (P < 0.05 for difference between treatments). Common carotid artery lumen diameter declined significantly only in patients treated with lisinopril [amlodipine, -0.02mm (-0.14, 0.10mm); lisinopril, -0.21mm (-0.32, -0.11mm); P < 0.02], while intima-media area declined similarly in the two treatment groups [amlodipine -1.32mm2 (-1.91, -0.74mm2), lisinopril -1.26mm2 (-1.80, -0.72mm2); not significant]. The results confirm that a decrease in BP causes regression of structural changes in the carotid artery in hypertensive patients. The nature of the structural regression differed markedly between the two treatment regimens, in spite of similar decreases in BP. The calcium channel blocker induced greater regression of common carotid artery intima-media thickness than the angiotensin-converting enzyme inhibitor. However, carotid artery wall mass, as indicated by intima-media area, was reduced to a similar extent by the two treatments. It remains to be established whether such differences confer a prognostic advantage.

scholarly journals Carotid Intima‐Media Thickness and the Risk of Sudden Cardiac Death: The ARIC Study and the CHS

2020 ◽  
Vol 9 (19) ◽  
Author(s):  
Takeki Suzuki ◽  
Wanmei Wang ◽  
Anthony Wilsdon ◽  
Kenneth R. Butler ◽  
Selcuk Adabag ◽  
...  
Keyword(s):  
Sudden Cardiac Death ◽  
Carotid Artery ◽  
Common Carotid Artery ◽  
Cardiac Death ◽  
Intima Media Thickness ◽  
Carotid Intima Media Thickness ◽  
Cardiovascular Health Study ◽  
Media Thickness ◽  
Increased Risk ◽  
Aric Study

Background Sudden cardiac death (SCD) is associated with severe coronary heart disease in the great majority of cases. Whether carotid intima‐media thickness (C‐IMT), a known surrogate marker of subclinical atherosclerosis, is associated with risk of SCD in a general population remains unknown. The objective of this study was to investigate the association between C‐IMT and risk of SCD. Methods and Results We examined a total of 20 862 participants: 15 307 participants of the ARIC (Atherosclerosis Risk in Communities) study and 5555 participants of the CHS (Cardiovascular Health Study). C‐IMT and common carotid artery intima‐media thickness was measured at baseline by ultrasound. Presence of plaque was judged by trained readers. Over a median of 23.5 years of follow‐up, 569 participants had SCD (1.81 cases per 1000 person‐years) in the ARIC study. Mean C‐IMT and common carotid artery intima‐media thickness were associated with risk of SCD after adjustment for traditional risk factors and time‐varying adjustors: hazard ratios (HRs) with 95% CIs for fourth versus first quartile were 1.64 (1.15–2.63) and 1.49 (1.05–2.11), respectively. In CHS, 302 participants developed SCD (4.64 cases per 1000 person‐years) over 13.1 years. Maximum C‐IMT was associated with risk of SCD after adjustment: HR (95% CI) for fourth versus first quartile was 1.75 (1.22–2.51). Presence of plaque was associated with 35% increased risk of SCD: HR (95% CI) of 1.37 (1.13–1.67) in the ARIC study and 1.32 (1.04–1.68) in CHS. Conclusions C‐IMT was associated with risk of SCD in 2 biracial community‐based cohorts. C‐IMT may be used as a marker of SCD risk and potentially to initiate early therapeutic interventions to mitigate the risk.

scholarly journals Increased intima-media thickness of the common carotid artery in hypercholesterolemic children.

1994 ◽  
Vol 14 (7) ◽  
pp. 1075-1079 ◽  
Author(s):  
P Pauciullo ◽  
A Iannuzzi ◽  
R Sartorio ◽  
C Irace ◽  
G Covetti ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
The Common

High Spatial Inhomogeneity in the Intima-Media Thickness of the Common Carotid Artery is Associated with a Larger Degree of Stenosis in the Internal Carotid Artery: The PARISK Study

2016 ◽  
Vol 38 (05) ◽  
pp. 523-529 ◽  
Author(s):  
Jeire Steinbuch ◽  
Anouk van Dijk ◽  
Floris Schreuder ◽  
Martine Truijman ◽  
Alexandra de Rotte ◽  
...  
Keyword(s):  
Risk Factors ◽  
Carotid Artery ◽  
Internal Carotid Artery ◽  
Common Carotid Artery ◽  
Internal Carotid ◽  
Intima Media Thickness ◽  
Media Thickness ◽  
Common Risk Factors ◽  
The Common ◽  
Ica Stenosis

Abstract Purpose Inhomogeneity of arterial wall thickness may be indicative of distal plaques. This study investigates the intra-subject association between relative spatial intima-media thickness (IMT) inhomogeneity of the common carotid artery (CCA) and the degree of stenosis of plaques in the internal carotid artery (ICA). Materials and Methods We included 240 patients with a recent ischemic stroke or transient ischemic attack and mild-to-moderate stenosis in the ipsilateral ICA. IMT inhomogeneity was extracted from B-mode ultrasound recordings. The degree of ICA stenosis was assessed on CT angiography according to the European Carotid Surgery Trial method. Patients were divided into groups with a low (≤ 2 %) and a high (> 2 %) IMT inhomogeneity scaled with respect to the local end-diastolic diameter. Results 182 patients had suitable CT and ultrasound measurements. Relative CCA-IMT inhomogeneity was similar for the symptomatic and asymptomatic side (difference: 0.02 %, p = 0.85). High relative IMT inhomogeneity was associated with a larger IMT (difference: 235 µm, p < 0.001) and larger degree of ICA stenosis (difference: 5 %, p = 0.023) which remained significant (p = 0.016) after adjustment for common risk factors. Conclusion Regardless of common risk factors, high relative CCA-IMT inhomogeneity is associated with a greater degree of ICA stenosis and is therefore indicative of atherosclerotic disease. The predictive value of CCA-IMT inhomogeneity for plaque progression and recurrence of cerebrovascular symptoms will be determined in the follow-up phase of PARISK.

Magnitude of alimentary lipemia is related to intima-media thickness of the common carotid artery in middle-aged men

1998 ◽  
Vol 141 (2) ◽  
pp. 307-314 ◽  
Author(s):  
Fredrik Karpe ◽  
Ulf de Faire ◽  
Michele Mercuri ◽  
M Gene Bond ◽  
Mai-Lis Hellénius ◽  
...  
Keyword(s):  
Carotid Artery ◽  
Common Carotid Artery ◽  
Intima Media Thickness ◽  
Middle Aged ◽  
Media Thickness ◽  
The Common
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