Comparison of Carotid Intima-media Thickness in Hypertensive Patients and Control Group

Intima-media thickness of femoral arteries and carotids among an adult hypertensive Nigerian population: A case-control study to assess their use as surrogate markers of atherosclerosis

Background:

Increased intima-media thickness (IMT) is an established and important surrogate marker for atherosclerosis. Intima-media thickening in the femoral arteries occur earlier and reflect the true extent of generalized atherosclerosis better than in the carotids. Aims: To study the ultrasound-detected morphological changes in the common femoral versus carotid artery wall.

Patients and Methods:

A case-control study design was used, with 61 adult hypertensive as cases and 61 age-, sex- and BMI-matched normotensive as controls. Variables were participants' characteristics, cardiovascular risk factors, and ultrasonographically evaluated IMT of the carotid and femoral arteries.

Results:

A total of 122 participants were studied. The mean femoral IMT in hypertensives and controls on the right and left was 0.63 ± 0.07mm vs. 0.52 ± 0.06mm [P < 0.0001] and 0.69 ± 0.0 mm vs. 0.55 ± 0.05mm [P < 0.0001]. Also, the mean carotid IMT among hypertensives and controls on the right =0.80 ±0.15mm vs. 0.64 ± 0.06mm [P < 0.0001], and 0.91 ± 0.22mm vs. 0.65 ± 0.06mm [P < 0.0001] on the left. Significant correlation was observed between IMT and age (B = 0.006, P < 0.001 and B = 0.003, P < 0.001), hypertension (B = 0.205, P < 0.001 and B = 0.122, p< 0.001), and duration of hypertension (B = 0.02, P < 0.001 and B = 0.006, P = 0.02) the femoral and carotid arteries respectively.

Conclusion:

The femoral and the carotid artery show similar significantly increased IMT in hypertensive adults. The femoral IMT appears to be a good surrogate marker of atherosclerosis among hypertensive Nigerians.

Comparison of Carotid Ultrasound Indices and the Triglyceride Glucose Index in Hypertensive and Normotensive Community-Dwelling Individuals: A Case Control Study for Evaluating Atherosclerosis

Background and objectives: Hypertension (HTN) is an important risk factor for cardiovascular diseases. High blood pressure is a major cause of atherosclerosis which leads to myocardial infarction and stroke. Insulin resistance (IR) is correlated with HTN and atherosclerosis. To determine differences between the effects of HTN on the intima media thicknesses (IMTs) of the internal (ICA), external (ECA), and common carotid arteries (CCA), and evaluate the carotid plaque presence between hypertensive and normotensive individuals, a case-control study was designed among community-dwelling individuals. The relationship between the triglyceride glucose (TyG) index and atherosclerosis was also investigated in this study. Materials and Methods: Data from 77 hypertensive and 199 normotensive individuals were analyzed in this study. Results: The IMTs of the CCA, ICA, and ECA, and the TyG index were all higher in hypertensive individuals compared to the control group (all p < 0.05). After controlling for age, sex, the body-mass index, and TyG index, HTN was an independent predictor of a high CCA IMT (odds ratio (OR) = 2.48; 95% confidence interval (CI) = 1.24–4.93) and presence of plaque (OR = 2.36; CI = 1.15–4.85) in the carotid artery. Conclusions: HTN was an independent risk of carotid IMT thickening and atherosclerosis. TyG index could only predict the CCA IMT independent of other risk factors (OR = 2.09; CI = 1.07–4.09).