Alteration of carotid circulation in essential hypertensive patients with left ventricular hypertrophy

Abstract

To investigate carotid haemodynamic characteristics in essential hypertensive patients with left ventricular hypertrophy, we evaluated the structure and function as well as blood flow of the common carotid artery by using a combination of B-mode ultrasound and pulsed-Doppler in control subjects (n = 38), and hypertensive patients with (n = 40) and without (n = 27) left ventricular hypertrophy. Hypertensive patients had a higher intima-medial thickness compared with control subjects. Diastolic/systolic flow velocity ratio as well as flow volume ratio was significantly decreased in hypertensive patients with left ventricular hypertrophy in association with decline of distensibility of the common carotid artery. In the hypertensive patients with left ventricular hypertrophy, diastolic/systolic flow velocity ratio as well as flow volume ratio had significant correlation with diastolic blood pressure, pulse pressure and carotid arterial distensibility. These findings indicate that diastolic blood flow in the common carotid artery is impaired in hypertensive patients with left ventricular hypertrophy. Decreased distensibility and low diastolic perfusion pressure may be the underlying mechanisms.