Evaluation of carotid intima-media thickness and aortic elasticity in patients with nondipper hypertension

Echocardiography. 2014 May;31(5):663-8. doi: 10.1111/echo.12444. Epub 2013 Nov 13.

Abstract

Background: The relationship between cardiovascular diseases and the diurnal blood pressure (BP) rhythm was researched in many studies. It has been demonstrated that the nondipping pattern has been associated with target organ damage and worsened cardiovascular outcomes. The aim of our study was to assess the relationship between aortic elasticity parameters and carotid intima-media thickness (CIMT) and diastolic dysfunction in terms of "dipper" and "nondipper" hypertension subtypes.

Methods: A total of 60 hypertensive patients without known coronary heart disease were recruited to our study. All patients were classified as "dipper" or "nondipper" after ambulatory BP follow-up. Patients' left ventricular (LV) systolic and diastolic functions were assessed with transthoracic echocardiography. Ascending aorta diameters and CIMT were measured by ultrasonography and the elasticity parameters of aorta were calculated by using relevant formula.

Results: There were no significant differences between the groups with respect to demographic, biochemical data, and cardiovascular risk factors. Aortic stiffness was significantly increased in nondippers, whereas aortic strain and distensibility were significantly decreased (P = 0.005, P = 0.005, and P = 0.024, respectively). Carotid artery IMT was significantly increased in nondippers compared to dippers (P = 0.013). A significant correlation was noted between CIMT and mean BP. No significant difference was detected between 2 groups in terms of LV hypertrophy and diastolic dysfunction.

Conclusion: In our study, we showed that impairment of aortic elasticity parameters and increase in CIMT as a predictor of end organ damage were more often in the nondipper hypertensive patients.

Keywords: aortic stiffness; carotid intima-media thickness; nondipper hypertension.

MeSH terms

  • Aorta, Thoracic / diagnostic imaging
  • Aorta, Thoracic / physiopathology*
  • Blood Pressure / physiology*
  • Carotid Intima-Media Thickness*
  • Echocardiography / methods*
  • Elasticity
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / diagnostic imaging*
  • Hypertension / physiopathology
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • ROC Curve
  • Reproducibility of Results
  • Vascular Stiffness / physiology*