Carotid and brachial arterial enlargement in postmenopausal women with hypertension

Abstract

Objective 

The aim of this study was to test whether systemic hypertension influences brachial and carotid artery remodeling in postmenopausal women. A secondary aim was to evaluate the possible role of pulse pressure.

Methods 

We enrolled 100 postmenopausal women affected by hypertension (cases) and 100 women with blood pressure within the reference range (controls) matched for age and body mass index because the influence of these variables on artery diameter is well known. Clinical and biochemical parameters were also assessed. All women underwent B-mode ultrasonography to measure the carotid and brachial artery diameter.

Results 

The case group had significantly larger brachial and common carotid artery diameters than control groups (P < 0.001). This result did not change after correction for confounding variables. Indeed, the women with hypertension had higher glucose and insulin levels and greater carotid atherosclerosis prevalence than did the control population. A multivariate linear regression analysis showed a correlation between artery diameters and hypertension status in the whole population. To evaluate the influence of pulse pressure, each group (cases and controls) was divided into two subgroups, according to the group-specific pulse pressure median. The women with a pulse pressure rate higher than the median value had larger artery diameters compared with those with lower pulse pressure rates in both groups with and without hypertension.

Conclusions 

Hypertension can promote generalized artery enlargement, and pulse pressure also plays a role in artery remodeling. Interestingly, pulse pressure seems to influence arterial diameter in individuals with blood pressure within the reference range. The role of hypertension in artery remodeling behind age and the body mass index requires further investigations on the mechanisms underlying remodeling.

In Brief

Blood pressure is a known variable associated with large artery diameter and wall thickness. The present study confirms this fact but extends the knowledge, showing also an enlargement of brachial artery diameter.