title: Association between pulse pressure, carotid intima-media thickness and carotid and/or iliofemoral plaque in hypertensive patients.
abstract: Increased common carotid artery intima-media thickness (CCA-IMT) and carotid and/or iliofemoral (C/IF) plaque are frequent in subjects treated for hypertension, but their association with pulse pressure (PP) has rarely been studied. Using ultrasound techniques, CCA-IMT and C/IF plaques were studied in 323 hypertensive subjects, who were classified into four groups according to the adequacy of blood pressure (BP) control (systolic BP (SBP) <140 mmHg and diastolic BP (DBP) <90 mmHg) and PP (high or low). After adjustment for confounding variables, an increase in CCA-IMT was the only factor significantly and independently associated with high PP, irrespective of the effectiveness of blood pressure control and of antihypertensive drug treatment. CCA-IMT correlated with age, PP, waist-to-hip ratio, tobacco consumption, and heart rate. C/IF plaques correlated with age, tobacco consumption, diabetes mellitus, and dyslipidaemia. To conclude, even with SBP<140 mmHg and DBP<90 mmHg on treatment, hypertensive subjects may have increased CCA-IMT values and C/IF plaque. Four cardiovascular risk factors seem to be involved in these alterations, namely tobacco consumption, dyslipidaemia, diabetes and increased PP. Only the latter factor does not have a standardized effective treatment.
authors.affiliation: Department of Cardiology, Beaujon Hospital, Clichy, France. jean-michel.tartiere@bjn.ap-hop-paris.fr
authors.forename: J-M
authors.initials: JM
authors.lastname: Tartière
authors.forename: L
authors.initials: L
authors.lastname: Kesri
authors.forename: H
authors.initials: H
authors.lastname: Safar
authors.forename: X
authors.initials: X
authors.lastname: Girerd
authors.forename: M
authors.initials: M
authors.lastname: Bots
authors.forename: M E
authors.initials: ME
authors.lastname: Safar
authors.forename: J
authors.initials: J
authors.lastname: Blacher
mesh_terms: D000368:Aged; D001794:Blood Pressure; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016893:Carotid Stenosis / Q000000981:diagnostic imaging*; D015331:Cohort Studies; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging*; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D007083:Iliac Artery / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D018084:Ultrasonography, Interventional