Control of Home Blood Pressure with an Amlodipine- or Losartan-Based Regimen and Progression of Carotid Artery Intima-media Thickness in Hypertensive Patients: The HOSP Substudy

Abstract Background Day-by-day home systolic blood pressure variability (BPV) was shown to be associated with increased common carotid artery (CCA) intima-media thickness (IMT) in the hypertensives. Recently, 24 hour ambulatory BPV was revealed to serve as an indicator of higher CCA-IMT only in males. However, there have been no studies that reported the sex-dependent relationship between day-by-day BPV and CCA-IMT. Purpose We assessed the hypothesis that day-by-day BPV was associated with higher CCA-IMT in the Japanese males at high-risk of cardiovascular disease. Methods Among 4310 patients with one or more cardiovascular risks recruited for the Japan Morning Surge-Home Blood Pressure Study, carotid ultrasound in CCA was performed in the 1365 patients (mean age 65.6 years old, male 52%). The home blood pressure (BP) readings during mean 11.2 days were used to calculate home mean levels and variability in morning systolic BP (SBP). Day-by-day BPV was measured as standard deviation [SD] and delta (maximum-minimum) in SBP. Results Average mean CCA-IMT of left and right side was 1.046±0.4mm. Mean (r=0.118, p<0.0001), SD (r=0.120, p<0.0001) and delta (r=0.149, p<0.0001) in morning SBP were significantly correlated with CCA-IMT. In the multiple regression analysis adjustment for confounders including age, gender, body mass index, total cholesterol, high density lipoprotein and mean morning SBP, SD (B: 0.008, 95% CI: 0.001–0.015, p<0.05) or delta (B: 0.004, 95% CI: 0.002–0.006, p<0.001) in morning SBP each had a significant association with CCA-IMT. According to the gender, SD (p<0.01) or delta (p<0.01) in morning SBP each was significantly associated with CCA-IMT only in the male group while neither SD (p=0.4) nor delta (p=0.4) in morning SBP was associated with CCA-IMT in the female group. Conclusions In addition to the conventional risk factors, day-by-day morning SBP variability was a significant indicator of increased CCA-IMT in the high-risk Japanese population. The significant relationship between day-by-day morning SBP variability and CCA-IMT was observed only in the males. Gender specific impact of day-by-day morning home systolic BPV on carotid artery atherosclerosis should be taken into account in the high-risk elderly at cardiovascular disease. Funding Acknowledgement Type of funding source: None

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Application of the Measurement of Carotid Intima-Media Thickness for Prediction of the Essential Hypertension in Children

Revista de Chimie ◽

10.37358/rc.18.6.6366 ◽

2018 ◽

Vol 69 (6) ◽

pp. 1550-1553

Author(s):

Rosana Manea ◽

Bianca Elena Popovici ◽

Carmen Daniela Neculoiu ◽

Dan Minea ◽

Alina Calin

Keyword(s):

Blood Pressure ◽

Essential Hypertension ◽

Carotid Artery ◽

Intima Media Thickness ◽

Carotid Intima Media Thickness ◽

Diagnostic Methods ◽

Control Group ◽

Study Group ◽

Media Thickness ◽

Hypertension In Children

Hypertension is a major risk factor for progression of the atherosclerotic process and for developing of degenerative cardiovascular diseases in adulthood. The aim of this study is to evaluate how the measurement of carotid intima - media thickness for prediction of essential hypertension in children can be used.The study group included 81 children and the control group 61 children, all aged between 5 - 17 years and 11 months old, and admitted in Children Hospital Brasov in the period of 2009 � 2014. The study protocol included: BMI, blood pressure and Doppler echography of the common carotid artery for each group. Mean age of the patients from the study group was 13.67 years, 43.20 % girls and 56.80 % boys, while in the control group, the mean age was 14.07 years, 54.10% girls and 45.90 % boys. 70.37% of the children from the study group presented obesity, while in the control group 40.98% were obese. The IMTC study group ranged from 0.52 - 0.69 mm and the limits of the normotensive subjects were 0.32 -0.54 mm. In both groups the obese patients were found to have increased carotid artery intima-media, which means that IMTC was positively correlated with BMI (p=0.000001).It is necessary to identify diagnostic methods easily applicable for children, allowing involvement of the characteristics of the arterial wall in the degenerative pathological processes. Increased intima-media ratio is positively correlated with high values of blood pressure.

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