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Association between common carotid artery diameter and target organ damage in essential hypertension

Yang, Yana; Wang, Yana; Xu, Jianzhonga; Gao, Pingjina,b

doi: 10.1097/HJH.0000000000001590
ORIGINAL PAPERS: Blood vessels

Objectives: To investigate the relationship between common carotid artery diameter (CCA-D) and target organ damage (TOD) in essential hypertension.

Methods and results: A total of 200 essential hypertensive patients were enrolled (mean age 62.5 ± 9.5, men 59.0%) and were classified into two groups by the height-adjusted mean median of CCA-D: patients with CCA-D/height less than 3.905 mm/m (n = 100, 50%) and patients with CCA-D/height more than 3.905 mm/m (n = 100, 50%). Patients with CCA-D/height more than 3.905 mm/m have higher left ventricular mass index (LVMI) (P < 0.001) and higher prevalence of left ventricular hypertrophy (LVH) (P < 0.001), higher mean common carotid intima–media thickness (P = 0.008) and higher prevalence of carotid artery sclerosis (P = 0.03), higher pulse wave velocity (PWV) (P < 0.001) and higher prevalence of increased arterial stiffness (P = 0.01), higher urinary albumin/creatinine ratio (P = 0.001) and higher prevalence of microalbuminuria (P = 0.02) and greater number of TODs (P < 0.001) compared with the patients with CCA-D/height less than 3.905 mm/m. CCA-D was significantly correlated with LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio (r = 0.299, P < 0.001; r = 0.212, P = 0.007; r = 0.224, P = 0.005, respectively) after adjusting for cardiovascular risk factors. Multivariable stepwise linear regression analysis showed that number of TODs as well as individual TOD, including LVMI, PWV and logarithmically transformed urinary albumin/creatinine ratio, were independently correlated to height-adjusted mean CCA-D (all P < 0.05).

Conclusion: Height-adjusted mean CCA-D was an independent risk factor for individual TOD, including LVMI, PWV and urinary albumin/creatinine ratio, as well as overall number of TODs in essential hypertension.

aDepartment of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine

bLaboratory of Vascular Biology, Institute of Health Sciences, Shanghai Institutes for Biological Sciences, Chinese Academy of Sciences, Shanghai, China

Correspondence to Pingjin Gao, Department of Hypertension, State Key Laboratory of Medical Genomics, Shanghai Key Laboratory of Vascular Biology, Shanghai Institute of Hypertension, Ruijin Hospital, Shanghai Jiaotong University School of Medicine, No. 197, Ruijin 2nd Road, Shanghai 200025, China. Tel: +86 21 64370045x610903; fax: +86 21 54654498; e-mail: gaopingjin@sibs.ac.cn, gaopingjincn@163.com

Abbreviations: ACE-I, medication with angiotensin-converting enzyme (ACE) inhibitor; Acr, urinary albumin/creatinine ratio; ARB, medication with AT1 blocker; BP, blood pressure; CCA, common carotid artery; CCA-D, common carotid artery diameter; CCB, medication with calcium channel blocker; hs-CRP, high sensitivity C-reactive protein; IMT, intima–media thickness; lg hs-CRP, logarithmically transformed high sensitivity C-reactive protein; lgAcr, logarithmically transformed urinary albumin/creatinine ratio; lgNT-proBNP, logarithmically transformed N-terminal pro-brain natriuretic peptide; LVMI, left ventricular mass index; NT-proBNP, N-terminal pro-brain natriuretic peptide; PWV, pulse wave velocity; TCtotal, cholesterol; TOD, target organ damage

Received 12 February, 2017

Revised 26 June, 2017

Accepted 9 September, 2017

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