Relationship between central blood pressure and carotid intima-media thickness in elderly hypertensive patients

Background Intima-media thickness(IMT) of the carotid artery is well-known to be a strong predictor of future vascular events and a surrogate marker of atherosclerosis. Central blood pressure(CBP) is more strongly related to cardiovascular events than brachial blood pressure. However, association between central blood pressure and carotid IMT was not studied in elderly patients with hypertension. Objective To investigate the relationship of CBP and carotid IMT in elderly hypertensive patients. Methods Ninety-seven cases of elderly hypertensive patients were selected, 75 cases normotensive served as controls group. CBP was detected noninvasively with SphygmoCor (At Cor Medical, Australia) device, and carotid IMT was measured with high resolution ultrasound. Results Central systolic pressure (CSP) [(146.6±8.5) vs (107.2±6.7) mm Hg], central diastolic pressure (CDP) [(91.1±10.3) vs (69.2±5.7) mm Hg], central pulse pressure (CPP) [(67.8±7.3) vs (38.4±7.3) mm Hg], central mean aortic pressure (CMAP) [(113.6±9.2) vs (83.1±6.2)mm Hg], central end systolic pressure(CESP) [(131.2±9.9) vs (94.5±5.1) mm Hg], augmentation pressure (AUG) [(18.0±8.7) vs (9.5±4.2) mm Hg], P1 Height [(52.4±10.3) vs (27.2±8.5)], augmentation index (AI) [(34.6±4.9) vs (25.2±7.3)%] and the IMT [(1.14±0.51) vs (0.74±0.61)mm] were significantly higher in elderly hypertensive than those in normotensives (P0.01). Adjusted for sex, age, smoking, systolic and diastolic blood pressure, multiple linear regression analysis showed total cholesterol, CSP, CPP, body mass index were independent risk factors affecting IMT (β values were 0.330, 0.247,0.185,0.205; all P0.05). Further adjustment for body mass index and blood lipid levels, CSP, CPP were still independent risk factors affecting IMT (β values were 0.260, 0.167; P values 0.003,0.041, respectively).ConclusionAtherosclerosis in elderly patients with hypertension is related to central aortic pressure and AI, CSP and CPP are independent atherosclerosis risk factors.