Introduction: Noncommunicable diseases taking form of pandemic and among them hypertension being commonest of all. Hypertensive patients are at higher risk of atherosclerosis, which in turn leads to increase incidence of MI and stroke. Intima media thickness (IMT) carotid arteries is known to reflect vascular system atherosclerosis as whole. There are limited numbers of studies assessing these parameters in hypertensive patients in Indian population.

Aim: To assess and compare carotid artery Intima-media thickness (IMT) in hypertensive patients and normotensive subjects using high frequency ultrasound.

Materials and Methods: In a case control study, 83 hypertensive patients and 83 normotensive individuals were included as cases and control respectively. After a thorough history taking and clinical examination both the groups were subjected to IMT assessment using high frequency ultrasonography and statistical analysis was done using SPSS.

Results: IMT in all carotid arteries in the hypertensive group was more than that of the normotensive (P < 0.05). It was found that there was no difference between the duration of hypertension and mean IMT in the hypertensive patients.

Conclusion: The present study found that the mean IMT of all carotid arteries in hypertension was more than that of the normotensives, therefore IMT can be used as early evidence of atherosclerosis and with preventive and promotive interventions the consequences of atherosclerosis can be minimized.

Keywords: Atherosclerosis, carotid intima-media thickness, Hypertension, Ultrasound, Rural.

1. Kannel WB. Blood pressure as a cardiovascular risk factor: prevention and treatment. 1996; 275: 1571–76.
2. Palmer AJ, Bulpitt CJ, Fletcher AE, Beevers G, Coles EC, Ledingham JG, et al. Relation between blood pressure and stroke mortality. Stroke. 1992; 20: 601–05.
3. Poli A, Tremoli E, Colombo A. Ultrasonographic measurement of the common carotid artery wall thickness in hypercholesterolemic patients: a new model for the quantification and follow up of preclinical atherosclerosis in living human subjects. Atherosclerosis.1988; 70:253–61.
4. Gnasso A, Irace C, Mattioli PL, Pujia A. Carotid intimamedia thickness and coronary heart disease risk factors. Atherosclerosis. 1996; 119:7–15.
5. Jaroch J, Loboz Grudzien K, Bociaga Z, Kowalska A, Kruszynska E, Wilczynska M, et al. The relationship of carotid arterial stiffness to left ventricular diastolic dysfunction in untreated hypertension. Kardiol Pol. 2012;70:223–31.
6. Su TC, Chien KL, Jeng JS, Chen MF, Hsu HC, Torng PL, et al. Age- and gender-associated determinants of carotid intima-media thickness: A community-based study. J Atheroscler Thromb. 2012;19:872–80.
7. Takiuchi S, Rakugi H, Fujii H, Kamide K, Horio T, Nakatani S, et al. Carotid intima-media thickness is correlated with impairment of coronary flow reserve in hypertensive patients without coronary artery disease. Hypertens Res.2003;26:945–51.
8. Ekundayo OJ, Allman RM, Sanders PW, et al. Isolated systolic hypertension and incident heart failure in older adults: a propensity-matched study. Hypertension. 2009;53(3):458-65.
9. Salonen R. Salonen JT. Determinants of carotid intima media thickness: a population based ultrasonographic study in eastern finnish men. J Intern med. 1991;116: 225-31.
10. Lemne C, Jogestrand T, de Faire U. Non invasive assessment of vessel – wall changes in hypertensive and normotensive controls. Clin Physiol. 1992; 12: 497-502.
11. Bots ML, Hoes AW, Koudstaal PJ, Hofman A, Grobbee DE. Common carotid intima-media thickness and the risk of stroke and myocardial infarction: The rotterdam study. Circulation. 1997; 96: 1432-37.
12. Rauramaa R, Väisänen S, Mercuri M, Rankinen T, Penttilä I and Bond MG. Association of risk factors and body iron status to carotid atherosclerosis in middle-aged Eastern Finnish men. Eur Heart J. 1994; 15:1020-27.
13. Sun P, Dwyer KM, Merz CNB, Sun W, Johnson CA, Shircore AM et al. Blood pressure, LDL cholesterol, and intima-media thickness. A test of the “response to injury” hypothesis of atherosclerosis. Arterioscler Thromb Vasc Biol. 2000;20:2005-10.
14. Adaikkappan M, Sampath R, Felix AJW, Sethupathy S. Evaluation of carotid atherosclerosis by b’mode ultrasonographic study in hypertensive patients compared with normotensive patients. Ind J Radiol Imag. 2002; 12:3:365-68.
15. Prabhu PS, Indiran V, maduraimuthu. Evaluation of Carotid Intima Media Thickness and Resistive Index by High Resolution Ultrasound in Hypertensive Patients and Normotensive Subjects –A Comparative Study. International Journal of Anatomy, Radiology and Surgery.2016 Jan;5(1):75-79.
16. Reddy KS, Yusuf S. Emerging epidemic of cardiovascular disease in the developing countries. Circulation.1998; 97: 596–601.

Dr Prabhat Kumar Agrawal

Associate Professor, Dept of Medicine, UPUMS, Saifai, Etawah (UP) – 206130

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