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Carotid elasticity is impaired in stage 1 hypertensive patients with well-controlled blood pressure levels

Journal of Human Hypertension volume 36, pages 898–903 (2022)Cite this article

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A Correction to this article was published on 04 July 2022

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Abstract

Whether impaired arterial elasticity in stage 1 hypertension can be brought back to normal by antihypertensive treatment is unknown. Aim of this study was to evaluate the impact of long-term well-controlled blood pressure (BP) on carotid artery elasticity and endothelial function in stage 1 hypertensive patients. We studied 40 middle-age hypertensives (mean age 49.7 years) whose BP had been kept at target by pharmacological treatment and/or lifestyle modifications for a mean of 7.5 years. Carotid compliance coefficient (CC) and distensibility coefficient (DC) were measured by B-mode ultrasound system. Measurement of carotid intima-media thickness (IMT) was performed in each carotid artery segment, bilaterally. Endothelial function was evaluated by post-occlusion flow mediated dilation (FMD). Forty normotensive subjects matched for age and sex served as controls. In the hypertensive subjects, BP levels were well controlled throughout the study period (mean office BP 133.7 ± 9.0/81.27 ± 7.0 mmHg). However, compared to controls, significantly higher office BP levels and waist circumference were present. Compared to normotensives, carotid elasticity (DC 24.5 ± 9.0 vs 37.0 ± 8.5 10−3/kPa, and CC 0.92 ± 0.34 vs 1.28 ± 0.36 mm2/kPa, p < 0.0005 for both) as well as endothelial function (FMD 5.7 ± 2.4% vs 9.2 ± 2.9%, p < 0.0005) were significantly impaired in hypertensives. In a logistic regression, hypertensive patients had increased risk of impaired carotid vascular stiffness (odds ratio, 95% CI: 13.04 (2.27−74.96), p = 0.004). Despite the “pseudo-normalization” of BP levels, hypertensive patients with long-term well-controlled BP according to current standards exhibited increased local arterial stiffness and endothelial dysfunction suggesting that lower BP targets should be sought.

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Fig. 1: Local arterial stiffness parameters in normotensive and hypertensive subjects.
Fig. 2: Correlation between local arterial stiffness parameters with cumulative mean of maximum-intima media thickness recorded in each carotid artery segments in both sides (M-Max) and flow mediated dilation.

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Acknowledgements

The authors acknowledge the Biomedical Foundation for Cardiovascular Research and Gene Therapy of Padova, Italy, (a non-profit Institution of the University of Padova), Padova, Italy.

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Authors and Affiliations

  1. Cardiology Unit, Cittadella Town Hospital, Cittadella, Padova, Italy

    Francesca Saladini

  2. Department of Medicine, DIMED, University of Padova, Padova, Italy

    Francesca Saladini, Marcello Rattazzi, Elisabetta Faggin & Paolo Palatini

  3. Medicina Interna I^, Ca’ Foncello Hospital, Treviso, Italy

    Marcello Rattazzi

  4. Medicine Unit, Mirano Town Hospital, Mirano, Venezia, Italy

    Massimo Puato

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Contributions

MP and SF contributed to the conception or design of the work. MP, SF, MR, EF, and PP contributed to the acquisition, analysis, and interpretation of data for the work. MP and SF drafted the manuscript. PP critically revised the manuscript. All authors gave final approval and agree to be accountable for all aspects of work ensuring integrity and accuracy.

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Correspondence to Francesca Saladini.

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The original online version of this article was revised: Due to an error in an author name.

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Saladini, F., Rattazzi, M., Faggin, E. et al. Carotid elasticity is impaired in stage 1 hypertensive patients with well-controlled blood pressure levels. J Hum Hypertens 36, 898–903 (2022). https://doi.org/10.1038/s41371-021-00584-7

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