Carotid Intima-Media Thickness and Plaque in Borderline Hypertension

Abstract

Background and Purpose In this study, we investigated intima-media thickness and plaque occurrence in the carotid arteries of men with borderline hypertension compared with that in normotensive control subjects and investigated the relations of these variables to atherosclerotic risk factors. Methods Using B-mode ultrasonography, we compared carotid artery intima-media thickness and plaque occurrence in men with borderline hypertension (diastolic blood pressure of 85 to 94 mm Hg, n=73) with that in age-matched normotensive control subjects (diastolic blood pressure of 80 mm Hg, n=72). We evaluated the relationships of intima-media thickness and plaque occurrence to atherosclerotic risk factors such as age, smoking, lipoprotein levels, and fasting insulin levels. Results The borderline hypertensive group exhibited a slight increase in overall intima-media thickness (0.73 versus 0.69 mm, P =.07), which was most evident in the right carotid artery (0.72 versus 0.67 mm, P <.05). There were more borderline hypertensive subjects with plaque (26% versus 16%, NS), again more evident on the right side (18% versus 6%, P <.05). Age and high-density lipoprotein cholesterol were consistently related to intima-media thickness ( t =1.94 to 3.24 and t =−2.25 to −2.69, respectively, P <.05), whereas age was the only significant determinant for plaque/nonplaque (F=6.4, P <.05). In addition, there was a significant difference in intima-media thickness between the right and left carotids, irrespective of group (F=4.43, P <.05). Conclusions Our results indicate that vascular structural changes occur even in borderline hypertension, although this seems more related to general atherosclerotic risk factors than to blood pressure alone. Additionally, a possible difference in the development of atherosclerotic lesions of the left and right carotid arteries is suggested, emphasizing the importance of measuring and reporting values from both sides when studying carotid intima-media thickness and plaque occurrence.