The change in carotid intima-media thickness in prehypertensive adults

Kim, Sung Jin; Jung, Kap Sung; Lee, Kwang Ho; Choi, Soo Hee; Lee, Kyung Eun; Lee, Sung Ho; Lee, Kwang Je; Kim, Sang Wook; Kim, Tae Ho; Kim, Chee Jeong; Ryu, Wang Seong

Abstract

BACKGROUND: Prehypertension is a precursor of clinical hypertension and tends to increase in severity over time. Structural vascular changes have not been much investigated in adults with prehypertension.
METHODS
We investigated the carotid intima-media thickness (IMT) in prehypertensive adults, pharmacologically untreated, compared with normotensive and hypertensive patients. Mean and maximum carotid IMT were obtained from six far walls of the common carotid, the bifurcation, and the internal carotid artery on both sides of the neck with high-resolution B-mode ultrasonography.
RESULTS
Mean IMT was largest in the carotid bifurcation, followed by the common carotid and the internal carotid artery in all groups. Hypertensives had higher mean IMT values at all locations than normotensive controls. In prehypertensive adults, the mean and maximum IMT values were significantly higher than in normotensive controls. In contrast, there was no significant difference in the mean and maximum carotid IMT between prehypertensive adults and patients with stage 1 hypertension. The prevalence of plaques was 15.7% in prehypertensive adults, compared with 4.4% in controls, 22.2% in stage 1 hypertensives, and 29.4% in stage 2 hypertensives.
CONCLUSION
Prehypertensive adults had thicker mean carotid IMT than normotensive controls and exhibited similarly abnormal carotid structure as the patients with stage 1 hypertension. These results suggest we need the continuous evaluation for early clinical detection and intervention of prehypertension.