Factors influencing hemodynamic and morphological indicators of carotid arteries atherosclerosis in treated hypertensive patients

摘要

Abstract Objectives: To evaluate factors influencing resistive index (Rl) and intima-media thickness of common carotid artery (IMT-CCA) as indices of arterial atherosclerosis in hypertensive patients.Methods: 56 treated hypertensive outpatients (mean age 68.9+-9.7 years; 31 diabetics) were examined. Fasting blood glucose, cholesterol, and HbA_(1c) concentration and glomerular filtration rate were measured. Systolic (SBP), diastolic blood pressure (DBP) and pulse pressure were estimated during ambulatory blood pressure monitoring. Ultrasonography of the CCA was performed with determination of IMT-CCA and Rl.Results: With diabetes IMT-CCA was significantly (1.025 +- 0.17 vs 0.928 +-0.18 mm, p = 0.04) and Rl not significantly (0.71 +-0.06 vs0.68+-0.08,p = 0.07) higher. Acorrelation between HbA_(1c) and Rl, IMT-CCA and the age was found. After dividing the whole group into subgroups corresponding to the tertiles of HbA_(1c) levels, mean IMT-CCA values in I and II tertile were significantly lower than in III tertile (p = 0.008 and p = 0.002 respectively), while Rl was significantly higher in III tertile than in I tertile (p = 0.03). On multiple regression analysis IMT-CCA was significantly influenced by the age (0 = 0.343, p = 0.04), SBP (0 = 0.430, p = 0.03) and HbA_(1c) (0 = 0.369, p = 0.01), while Rl was influenced by SBP (0 = 0.696, p = 0.0006), DBP (0 = -0.618, p = 0.003) and HbA_(1c) (0 = 0.279, p = 0.04).Conclusion: Patients with hypertension and diabetes mellitus had significantly increased IMTand not significantly higher Rl. Concentration of HbA_(1c), next to the age, SBP and DBP values was independently associated with IMT-CCA and Rl - parameters determining indirectly the degree of atherosclerosis of common carotid artery.