Local carotid stiffness and intima-media thickness assessment by a novel ultrasound-based system in essential hypertension.

Abstract Objective To evaluate local carotid stiffness (CS) and intima-medial thickness (C-IMT) in hypertensive patients with different cardiovascular risk profile, using a new user-friendly ultrasound-based system, previously validated vs. RF-based echotracking device. Methods We investigated a population with different cardiovascular risk: 45 healthy normotensives (NT), 90 non-diabetic hypertensives (HT), and 48 patients with hypertension and type-2 diabetes (DM). Framingham risk factor score (FRS) was calculated. PWV was assessed by applanation tonometry. The relative stroke change in diameter (Δ D ) and C-IMT were measured on carotid scans. Distensibility coefficient (DC) was calculated as Δ A /( A *Δ P ), where A  = diastolic lumen area, Δ A  = stroke change in lumen area, and Δ P  = carotid pulse pressure. CS (m/s) was calculated as ( ρ *DC) − 1/2 ( ρ  = blood density). Results CS, C-IMT, PWV were significantly increased in HT and DM vs. NT. C-IMT and PWV were significantly higher in DM than HT. Δ D and DC were significantly lower in HT and DM vs. NT. FRS ≥10% group showed increased carotid diameter, C-IMT and CS than the FRS p r  = 0.35); Δ D ( r  = −0.36), DC ( r  = 0.35), C-IMT ( r  = 0.48), PWV ( r  = 0.38). CS correlated ( p r  = 0.37), in the NT ( r  = 0.35), in the HT and DM ( r  = 0.20). PWV ( r  = 0.50) and CS ( r  = 0.33) were correlated with age. Determinants of aortic and carotid stiffness were identified by multivariate stepwise analysis. Conclusions The proposed B-mode ultrasound-based system is a reliable and user-friendly method that could serve to investigate the predictive value of CS for cardiovascular events in future large clinical studies.