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P8.2 Progression of Carotid Artery Remodeling and Stiffness in Hypertensive Patients with or Without Diabetes Mellitus: A Cohort Prospective Study

Abstract

Aim

To evaluate the progression over time of carotid and aortic stiffness and carotid remodeling in hypertensive patients, according to the presence of diabetes mellitus.

Methods

In this prospective observational study, 124 hypertensive patients (32 with Type 2 diabetes —HTDM -, 92 without - HT) were evaluated at Visit 0 (V0) and after a 3.4±1.0-year follow-up (V1). Carotid-femoral pulse wave velocity (PWV), carotid intima-media thickness (cIMT), carotid stiffness (CS) and circumferential wall stress (CWS) were assessed.

Results

In HT BP was unchanged, due to increased antihypertensive drugs (1.3±1 to 1.7±0.8, p=0.001); in HTDM there was a decrease in DBP (82.5±9.1 to 76.2±8.6mmHg, p=0.006) and an improvement of metabolic control (blood glucose 168±45 to 147±31mg/dl; LDL 104±34 to 82±24mg/dl, p≤0.05). At V0 PWV, cIMT and CS were significantly higher in HTDM than in HT (10.9±2.1 vs 8.6±1.5m/s, p<0.0001; 808±125 vs 731±151µm, p=0.01; 7.23±1.25vs 6.69±1.21m/s, p=0.03 respectively). These variables were unchanged during follow-up. Conversely carotid diameter, which was similar in the two groups at V0, increased in HT (7.47±1.11 to 7.8±0.8mm, p=0.01) but not in HTDM (7.7±0.9 to 7.7±0.8mm, p=0.83) as well as CWS (HT 55±12 to 59±17kPa, p=0.03; HTDM 52±13 to 54±21kPa, p=0.53).

Conclusions

In a cohort of hypertensive patients, followed-up for about 3 years and treated according to routine clinical practice, aortic and carotid stiffness, as well as cIMT did not change over time. Interestingly, in non-diabetic hypertensive patients there was a progression of carotid artery maladaptive remodeling, suggesting lower efficacy of conventional treatment on this vascular feature.

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This is an open access article distributed under the CC BY-NC license http://creativecommons.org/licenses/by/4.0/.

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Bruno, R., Barzacchi, M., Cartoni, G. et al. P8.2 Progression of Carotid Artery Remodeling and Stiffness in Hypertensive Patients with or Without Diabetes Mellitus: A Cohort Prospective Study. Artery Res 8, 151–152 (2014). https://doi.org/10.1016/j.artres.2014.09.177

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  • DOI: https://doi.org/10.1016/j.artres.2014.09.177