Descriptive study of the relationship between the subclinical carotid disease and biomarkers, carotid femoral pulse wave velocity in patients with hypertension.

BACKGROUND

Carotid intima-media thickness (cIMT) is a significant early prediction signal for preclinical atherosclerosis. Plasma homocysteine (Hcy) level is an independent risk factor for cardiovascular diseases. Pulse wave velocity (PWV), an index of arterial stiffness (AS), has showed its value in the evaluation of AS in vascular-related diseases. The data regarding the relationships between cIMT and other indices of vascular damage are limited and partly controversial. We aim to investigate the relationships between cIMT and other indices of vascular damage such as Hcy and carotid femoral PWV (CF-PWV).

METHODS

In total,1188 (male/female 514/674) subjects with hypertension from Vascular Medicine of Peking University Shougang Hospital were enrolled into our study. The patients with hypertension were measured bilateral cIMT by B-mode ultrasound and measured plasma levels of Hcy, total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), C-reactive protein (CRP), glucose, and other biomarkers. Plaques were detected in 78% of the study patients. Plasma Hcy (p < 0.001), CRP (p <  0.001), LDL (p < 0.001), HDL (p = 0.008), TC levels (p < 0.001), and CF-PWP (p < 0.001) were significantly greater in hypertensive patients with carotid plaques than patients without. The carotid plaque detection rate (p < 0.001) and bilvertebral artery max velocity (p < 0.05) were significantly different in quartiles of plasma Hcy levels. R-IMT correlated significantly with HCY, high sensitive CRP (hs-CRP), CF-PWV, and R-vertebral artery intimal diameter. Age (p < 0.001) and CF-PWV (p < 0.05) predicted the presence of carotid plaques independently in the logistic regression. However, Hcy did not independently predict the presence of carotid plaques in the logistic regression.

CONCLUSION

Increased carotid femoral PWV and elevated plasma Hcy levels are associated with subclinical carotid disease in hypertensive patients. CF-PWV independently predicted subclinical carotid plaque in the patients with hypertensive. While, there is insufficient evidence for Hcy in predicting plaque incidence.