title: Arterial stiffness is associated with carotid atherosclerosis in hypertensive patients (the Campania Salute Network).
abstract: BACKGROUND
  Pulse pressure/stroke volume indexed to height(2.04) (PP/SVi) is a validated measure of arterial stiffness, but its relation to carotid atherosclerosis is unknown.
  
  
  METHODS
  Clinical, echocardiographic, and carotid ultrasound data from 6,209 hypertensive patients without prevalent cardiovascular (CV) disease in the Campania Salute Network were analyzed. The population was grouped into tertiles of PP/SVi. From carotid ultrasound, peak and mean intima-media thickness (IMT) and presence of carotid plaques in the common and internal carotid arteries were reported.
  
  
  RESULTS
  Increasing PP/SVi tertile was associated with a parallel increase in age, blood pressure, total serum cholesterol and the number of antihypertensive drugs used (all P < 0.01). Higher PP/SVi was also associated with greater peak and mean IMT (all P < 0.01), also when adjusting for age, gender, blood pressure, lipid profile, and diabetes mellitus (all P < 0.01). Similarly, compared to the lower PP/SVi tertile, the multiple adjusted prevalence ratio of carotid plaque was 7 (95% confidence interval (CI) 1-13, P < 0.03) in the middle tertile and 21 (95% CI 15-28, P < 0.0001) in the upper tertile, independently of confounders.
  
  
  CONCLUSIONS
  In treated hypertensive patients participating in the Campania Salute Network, higher PP/SVi is associated with carotid atherosclerosis independent of well-known clinical confounders.
authors.affiliation: Department of Clinical and Experimental Medicine, Federico II University Hospital, Napoli, Italy.
authors.forename: Giuseppina
authors.initials: G
authors.lastname: Casalnuovo
authors.forename: Eva
authors.initials: E
authors.lastname: Gerdts
authors.forename: Giovanni
authors.initials: G
authors.lastname: de Simone
authors.forename: Raffaele
authors.initials: R
authors.lastname: Izzo
authors.forename: Marina
authors.initials: M
authors.lastname: De Marco
authors.forename: Renata
authors.initials: R
authors.lastname: Giudice
authors.forename: Bruno
authors.initials: B
authors.lastname: Trimarco
authors.forename: Nicola
authors.initials: N
authors.lastname: De Luca
mesh_terms: D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D002784:Cholesterol / Q000097:blood; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D013318:Stroke Volume; D059289:Vascular Stiffness
chemical_list: D000959:Antihypertensive Agents; D002784:Cholesterol