Carotid intima-media thickness in confirmed prehypertensive subjects: predictors and progression.
OBJECTIVE
The purpose of this study was to test whether carotid intima-media thickness (IMT) is already increased in normotensive subjects who progress to hypertension (confirmed prehypertensives) independently of known determinants of vessel wall thickness.


RESULTS
Common carotid artery (CCA) far-wall IMT was measured (B-mode ultrasound) in 1536 subjects from the population-based Mexico City Diabetes Study at baseline and 3.5 years later. In the 136 confirmed prehypertensives, CCA-IMT (720 [253] microm, median[interquartile range]) was intermediate between normotensives (615 [140] microm) and hypertensives (725 [215] microm). After multiadjusting for gender, age, BMI, blood pressure, total cholesterol, antihypertensive therapy, and diabetes, converter status was independently associated with a higher CCA-IMT (+93+/-14 microm). At follow-up, CCA-IMT increased by 35 [180] microm. Gender, age, blood pressure, and presence of diabetes, but not the converter status, were significant independent predictors of CCA-IMT progression. In a model adjusting for gender, age, blood pressure (level, status and treatment), diabetes status, total and HDL-cholesterol, the G variant of the 45T/G polymorphism of the adiponectin gene was associated with a hazard ratio of 1.45 (95% CI: 1.04 to 2.01) of a baseline CCA-IMT in the top quintile.


CONCLUSIONS
In confirmed prehypertensives, CCA-IMT is increased independently of blood pressure and known determinants of wall thickness, but short-term CCA-IMT progression is not accelerated.
Department of Internal Medicine and Metabolism Unit of the C.N.R. Institute of Clinical Physiology.
Romana
R
Femia
Michaela
M
Kozakova
Monica
M
Nannipieri
Clicerio
C
Gonzales-Villalpando
Michael P
MP
Stern
Steven M
SM
Haffner
Ele
E
Ferrannini
D052242:Adiponectin / Q000235:genetics; D000328:Adult; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000235:genetics / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000473:pathology*; D019992:Databases as Topic; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D020022:Genetic Predisposition to Disease; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008800:Mexico; D008875:Middle Aged; D011110:Polymorphism, Genetic; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography
C499918:ADIPOQ protein, human; D052242:Adiponectin