Influence of hypertension on early carotid artery remodeling
Influence of hypertension on early carotid artery remodeling
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DOI：
10.1161/01.atv.0000083342.98342.22
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发表时间：
2003-08-01
影响因子：
8.7
通讯作者：
Simon, A
中科院分区：
文献类型：
--
作者：
Chironi, G;Gariepy, J;Simon, A
目的：分析高血压对早期大动脉重塑的影响。方法与结果：对394例正常血压受试者、327例未治疗和528例接受治疗的高血压患者的颈动脉内中膜厚度(IMT)和内径进行了超声测量。与正常血压组相比，治疗或未治疗的高血压组的颈动脉内膜中层厚度和内径均增加(P<；0.001)。在整个研究人群中，直径与颈动脉内膜厚度之间存在正相关(P<；0.001)，并且这种关联与临床组别之间存在交互作用(P<；0.01)。正常血压组、高血压未治疗组和高血压治疗组之间直径-IMT关系斜率不同(P<；0.01)，高血压治疗组显著高于高血压未治疗组和正常血压组(P<；0.05，P<；0.01)。调整血压、降脂治疗或多个协变量(年龄、性别、收缩和舒张压、体重指数、降脂治疗、吸烟和既往心血管疾病)并不能消除临床组之间直径-IMT斜率的差异(P<；0.01)。结论：与正常血压状态相比，未经治疗的高血压患者颈动脉壁厚度增加的敏感性没有改变，但经降压治疗后发生了改变。
Objectives - We aimed to analyze the influence of hypertension on early large artery remodeling.Methods and Results - Carotid intima-media thickness (IMT) and diameter were measured ultrasonographically in 394 normotensive subjects and 327 untreated and 528 treated hypertensive patients. IMT and diameter were increased in hypertensive groups, treated or untreated, compared with the normotensive group ( P < 0.001). Positive association existed between diameter and IMT in the overall study population ( P < 0.001), and this association interacted with the category of clinical groups ( P < 0.01). The slope of the diameter-IMT relationship was different between normotensive, untreated hypertensive, and treated hypertensive groups ( P < 0.01), with higher value in the treated hypertensive group than in untreated hypertensive and normotensive groups ( P < 0.05, P < 0.01). Adjustment for blood pressure, lipid-lowering therapy, or multiple covariates ( age, sex, systolic and diastolic blood pressures, body mass index, lipid-lowering therapy, smoking, and previous cardiovascular disease) did not abolish the diameter-IMT slope difference between clinical groups ( P < 0.01).Conclusions - The sensitivity of carotid artery enlargement in response to increase in wall thickness was unchanged in untreated hypertension but altered by antihypertensive therapy compared with the normotensive condition.