Intima–Media Thickness Is Linearly and Continuously Associated With Systolic Blood Pressure in a Population‐Based Cohort (STANISLAS Cohort Study)

Abstract

Background Carotid intima–media thickness ( cIMT ) is a noninvasive marker of cardiovascular risk. The cIMT may be increased in patients with harmonisation, but little is known regarding the functional form of the association between blood pressure ( BP ) and cIMT in hypertensive and nonhypertensive persons. We aimed to define the shape of the association between BP and cIMT . Methods and Results We studied cIMT and ambulatory BP monitoring data from a single‐center, cross‐sectional, population‐based study involving 696 adult participants from the STANISLAS cohort, a familial longitudinal cohort from the Nancy region of France. Participants with a history of hypertension were more likely to have a cIMT >900 μm and had higher mean cIMT (both P <0.001). The risk of cIMT >900 μm increased linearly with higher 24‐hour and daytime systolic BP in participants both with and without history of hypertension. The relationship between systolic BP and the risk of cIMT >900 μm was not dependent on hypertension status (all P for interaction >0.10). In multivariable analysis adjusted on cardiovascular risk factors, each 5‐mm Hg increase in systolic BP was associated with an 8‐μm increase in cIMT (β=8.249 [95% CI 2.490–14.008], P =0.005). In contrast, the association between diastolic BP and cIMT was weaker and not significant. Conclusions Systolic BP is linearly and continuously associated with higher cIMT in both hypertensive and nonhypertensive persons, suggesting a detrimental effect of BP on the vascular tree prior to overt hypertension. Similarly, it suggests a detrimental effect of BP at the higher end of the normal range in treated hypertensive patients. Clinical Trial Registration URL : https://www.clinicaltrials.gov/ . Unique identifier: NCT 01391442.