1. ¹Division of Internal Medicine, Tokyo, Japan
2. ²Department of Psychiatry, Showa University Karasuyama Hospital, Tokyo, Japan
3. ³Third Department of Internal Medicine, Showa University School of Medicine, Tokyo, Japan

Correspondence: Dr. Takuya Watanabe, Division of Internal Medicine, Showa University Karasuyama Hospital, 6-11-11 Kita-karasuyama, Setagaya-ku, Tokyo 157-8577, Japan. E-mail: karas@js9.so-net.ne.jp

Received 7 January 2003; Revised 27 February 2003; Accepted 20 May 2003.

Abstract

Background: It has been proven that the intima–media thickness (IMT) of the carotid artery increases in patients with essential hypertension. Serum levels of insulin-like growth factor-1 (IGF-1) increase in hypertensive patients with ventricular hypertrophy. However, the relationship between carotid atherosclerosis and serum levels of IGF-1 and its binding protein-3 (IGFBP-3) in patients with essential hypertension has not been established.

Methods: The carotid IMT, blood pressure (BP), serum lipid profiles, and serum IGF-1 and IGFBP-3 contents were determined in 54 hypertensive patients (19 with and 35 without carotid plaque) and 52 normotensive controls without plaque.

Results: Systolic, diastolic, and mean BPs and serum IGFBP-3 level were significantly higher in the hypertensive patients (with and without plaque) than in the normotensive controls. The IGFBP-3 level correlated with systolic BP (r = 0.204, P = .0354). Age, gender, body mass index, and serum levels of HDL cholesterol, triglycerides, lipoprotein(a), lipid peroxides, insulin, and fasting plasma glucose did not differ significantly among the three groups. Hypertensive patients with plaque, compared with those without plaque or the normotensive controls, had the highest values of carotid IMT, LDL cholesterol, IGF-1, and IGFBP-3. Multiple logistic regression analysis revealed that the IGFBP-3 level was associated with a ninefold (95% confidence interval 2.6–31) higher risk of carotid plaque formation compared with LDL cholesterol or IGF-1 levels.

Conclusions: These results suggest that an increased level of IGFBP-3 may play a crucial role in the development of carotid atherosclerosis in hypertensive patients.