Subtype of hypertension is evidence for preclinical atherosclerosis. A study of carotid artery ultrasonography and biochemical markers

OBJECTIVE: To assess subclinical atherosclerosis in subtypes of hypertension using lipid profile as a biomarker and B mode ultrasonography of the carotid arteries.

METHODS: Ninety-six subjects (49 females and 47 males) aged 42-78 years were recruited from the vascular Doppler unit at Baghdad Teaching Hospital, Baghdad, Iraq from January to June 2008. They were grouped into normotensive (group I), isolated systolic hypertension (group II), isolated diastolic hypertension (group III), and combined systolic and diastolic hypertension (group IV).

RESULTS: Subclinical atherosclerosis was observed in groups III and IV in terms of significantly low levels of high-density lipoprotein, high levels of low-density lipoprotein, and high atherogenic index. The mean intima media thickness was significantly increased with transition from group I to group IV in all carotid arteries, and the mean resistive index value of each carotid artery in group IV was significantly higher than that of group I. Carotid plaque was demonstrated in a significantly higher percent in group IV (12 out of 15) followed by groups III (14 out of 31) and II (1 out of 30).

CONCLUSION: Lipid profile and high resolution B-mode ultrasonography of the carotids are good predictive measures of subclinical atherosclerosis. Isolated diastolic hypertension and combined systolic-diastolic hypertension accounts for early subclinical atherosclerosis compared with isolated systolic hypertension.