Clinical Study Of Carotid Atherosclerosis In Patients With Essential Hypertension

Objective This study was designed to determine the prevalence of carotid artery atherosclerosis(CAS) in patients with Essential Hypertension(EH).Methods 180 patients with EH were selected, 144 male, 36 female; 100 normotensive control subjects were selected, 79 male, 21 female. Doppler scans ultrasonics were performed on 180 participants of the EH in the patients and on 100 normotensive control subjects. To investigate the changes of carotid artery hemodynamics, the mean blood velocity(Vm), blood pulse index(PI) and blood resisent index(RI) of common carotid artery(CCA) and internal carotid artery(ICA) were measured; To quantify the extent of CAS, the intima-media thickness ( IMT ) and the intima-media thickness/diameter of CCA and ICA were measured, the maximal thickness measurements of all plaques were summed for an individual plaque score.Results (1) Vm of CCA and ICA in the second or third stage of EH was decreased significantly versus control group(P<0.01) and Vm of CCA in essential hypertensive group negatively correlated with age(P<0.01); but PI and RI of CCA and ICA in the second or third stage of EH increased significantly versus controls(f<0.05) and PI of CCA positive correlation with age(P<0.01); (2) IMTs of CCA and ICA were high significantly in the second or third stage of EH than those in normal subjects(P<0.05,P<0.01). There was an increasing trend for IMT with the severity of carotid artery plaque. In multiple linear regression stepwise analysis of all the subjectsrevealed that age, cigarette smoking, systolic blood pressure, length and severity of hypertension were independently associated with IMT of CCA. (3) The ratio of carotid artery plaque and plaque score were significantly increased in hypertensive groups versus control group(P<0.01).Conclusions (1) Formation of atherosclerosis plaque , reduction of blood flow speed, increases in the PK RI and IMT of carotid artery are the frequent abnormal findings in carotid arteries in essential hypertensive patients .(2) Increase in IMT of carotid arteries are clearly related to atherosclerosis plaque . (3) The severity of CAS may be used as a reference index for the prediction of cerebrovascular disease.