Carotid atherosclerosis, arterial stiffness and stroke events.
Assessment of intima-media thickness or of measures of large arteries compliance may identify patients at increased risk for stroke. In fact, carotid atherosclerosis and arterial stiffness are both related to risk factors associated with the occurrence of stroke. In addition, several cross-sectional studies have shown that risk factors associated with the occurrence of stroke have been correlated with carotid atherosclerosis development and progression and with increased arterial stiffness. Some studies have also shown that aortic stiffness is associated with the extent of atherosclerosis in the carotid and in other vascular beds. More importantly, longitudinal studies have demonstrated that carotid atherosclerosis and arterial stiffness are independent predictors of stroke (and other cardiovascular events). Interventional studies have demonstrated that treatment with statins, calcium antagonists, ACE inhibitors, and insulin sensitizers may be particularly effective on slowing the progression or favoring the regression of atherosclerotic changes, and may reduce large artery stiffness. It remains to be proven, in large prospective studies, whether the regression of increased arterial stiffness or of carotid intima-media thickness and plaque have a prognostic significance, i.e. are associated with a reduction of the risk of cerebrovascular events.
Agabiti-Rosei
Enrico
E
Internal Medicine, Department of Medical and Surgical Sciences, University of Brescia, Brescia , Italy.
Muiesan
Maria Lorenza
ML
D000319:Adrenergic beta-Antagonists / Q000627:therapeutic use; D047228:Angiotensin II Type 1 Receptor Blockers / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D002340:Carotid Artery Diseases / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D017536:Carotid Artery, Common / Q000503:physiopathology*; D004232:Diuretics / Q000627:therapeutic use; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000503:physiopathology* / Q000517:prevention & control; D017539:Tunica Intima / Q000187:drug effects / Q000503:physiopathology; D017540:Tunica Media / Q000187:drug effects / Q000503:physiopathology; D014655:Vascular Resistance / Q000187:drug effects
D000319:Adrenergic beta-Antagonists; D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D002121:Calcium Channel Blockers; D004232:Diuretics