title: Intima-media thickness remodelling in hypertensive subjects with long-term well-controlled blood pressure levels.
abstract: Aim of this study was to evaluate in a long follow-up the carotid artery remodelling in a cohort of young hypertensive subjects having good blood pressure (BP) control. We studied 20 grade I hypertensives (HT) by assessing the B-mode ultrasound of mean carotid intima-media thickness (mean-IMT) and maximum IMT (M-MAX) in each carotid artery segment (common, bulb, internal), bilaterally. We compared their ultrasound measurements with those recorded 5 and 10 years earlier. While the first 5-year follow-up was observational, in the second 5-year follow-up, lifestyle modifications and/or pharmacological therapy were started to obtain well-controlled BP levels. Office BP was measured at the time of the ultrasound studies and every 6 months during the follow-up. BP levels were: 10 years 144/91 mmHg, 5 years 143/90 mmHg and 129 ± 79 mmHg at the time of the study. In the first 5-year observational follow-up, both mean-IMT and M-MAX increased (Δ 0.116 and Δ 0.165 mm, respectively, p < 0.0005). In the 5-year intervention follow-up, characterized by well-controlled BP, mean-IMT slightly but significantly increased (Δ 0.084 mm, p = 0.004), whereas M-MAX remained stable (Δ 0.026 mm). In our HT, well-controlled BP levels were able to prevent pro-atherogenic remodelling (expressed by M-MAX). Conversely, good BP control slightly decreased but did not stop the progression in mean-IMT, which is likely to reflect some hypertrophy of the arterial media layer.
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Massimo
authors.initials: M
authors.lastname: Puato
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Boschetti
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.|b Medicina I, Ospedale Ca' Foncello , Treviso , Italy.
authors.forename: Marcello
authors.initials: M
authors.lastname: Rattazzi
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Zanon
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Raffaele
authors.initials: R
authors.lastname: Pesavento
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Faggin
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Fania
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Benetti
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Palatini
authors.affiliation: a Department of Medicine , University of Padova , Padova , Italy.|b Medicina I, Ospedale Ca' Foncello , Treviso , Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Pauletto
mesh_terms: D000328:Adult; D001794:Blood Pressure; D059168:Carotid Intima-Media Thickness; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D066253:Vascular Remodeling
keywords: Carotid artery; hypertension; intima-media thickness; ultrasound