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J Prev Med Public Health > Volume 42(5); 2009 > Article
Journal of Preventive Medicine & Public Health 2009;42(5): 298-304. doi: http://dx.doi.org/10.3961/jpmph.2009.42.5.298
Association of Blood Pressure Levels with Carotid Intima-Media Thickness and Plaques.
Young Hoon Lee, Sun Seog Kweon, Jin Su Choi, Jung Ae Rhee, Sung Woo Choi, So Yeon Ryu, Min Ho Shin
1Department of Preventive Medicine, College of Medicine, Seonam University, Korea.
2Jeonnam Regional Cancer Center, Chonnam National University Hwasun Hospital, Korea.
3Department of Preventive Medicine, Chonnam National University Medical School, Korea. mhshinx@paran.com
4Department of Preventive Medicine, Chosun University College of Medicine, Korea.
ABSTRACT
OBJECTIVES: The aim of this study was to investigate the association of blood pressure levels with the common carotid artery intima-media thickness (CCA-IMT) and carotid plaques. METHODS: Data were obtained from 2,635 subjects, aged 50 years and over, who participated in the Community Health Survey (a population-based, cross-sectional study) in Dong-gu, Gwangju city between 2007 and 2008. Participants were categorized into three groups according to blood pressure levels; normotensives (<120/80 mmHg), prehypertensives (120-139/80-89 mmHg), and hypertensives (> or =140/90 mmHg). Prehypertensives were further categorized as low prehypertensives (120-129/80-84 mmHg) and high prehypertensives (130-139/85-89 mmHg). Carotid intima-media thickness and plaques were evaluated with a high-resolution B-mode ultrasound. Statistical analyses were performed using chi-square test, ANOVA, and multiple logistic regression. RESULTS: Prehypertensives had significantly greater maximal CCA-IMT values than normotensives, with a multivariate adjusted odds ratio of 1.78 (95% CI=1.36-2.32) for abnormal CCA-IMT (maximal CCA-IMT > or =1.0 mm), and 1.45 (95% CI=1.19-1.77) for carotid plaques. The multivariate adjusted odds ratio of low prehypertensives was 1.64 (95% CI=1.21-2.21) for abnormal CCA-IMT, and 1.30 (95% CI=1.04-1.63) for carotid plaques compared with normotensives. Subject with hypertension had higher frequency of abnormal CCA-IMT (odds ratio, 2.18; 95% CI=1.49-3.18), and carotid plaques (odds ratio, 1.98; 95% CI=1.46-2.67) compared with normotensives after adjustment for other cardiovascular risk factors. CONCLUSIONS: Our results indicate that there is a significant increase in the prevalence of carotid atherosclerosis in subjects with prehypertension (even in low prehypertensives) compared with normotensive subjects. Further studies are required to confirm the benefits and role of carotid ultrasonography in persons with prehypertension.
Key words: Carotid arteries; Carotid stenosis; Hypertension; Ultrasonography
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