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Influence of Hypertension on Early Carotid Artery Remodeling

Objectives—We aimed to analyze the influence of hypertension on early large artery remodeling. Methods and Results—Carotid intima-media thickness (IMT) and diameter were measured ultrasonographically in 394 normotensive subjects and 327 untreated and 528 treated hypertensive patients. IMT and diameter were increased in hypertensive groups, treated or untreated, compared with the normotensive group (P <0.001). Positive association existed between diameter and IMT in the overall study population (P <0.001), and this association interacted with the category of clinical groups (P <0.01). The slope of the diameter-IMT relationship was different between normotensive, untreated hypertensive, and treated hypertensive groups (P <0.01), with higher value in the treated hypertensive group than in untreated hypertensive and normotensive groups (P <0.05, P <0.01). Adjustment for blood pressure, lipid-lowering therapy, or multiple covariates (age, sex, systolic and diastolic blood pressures, body mass index, lipid-lowering therapy, smoking, and previous cardiovascular disease) did not abolish the diameter-IMT slope difference between clinical groups (P <0.01). Conclusions—The sensitivity of carotid artery enlargement in response to increase in wall thickness was unchanged in untreated hypertension but altered by antihypertensive therapy compared with the normotensive condition.