Department of Neurology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, P. R. China.
BMC Cardiovasc Disord. 2013 Mar 19;13:20. doi: 10.1186/1471-2261-13-20.
The proceeding of blood pressure (BP) from normal level to the hypertension has been found to be associated with increased cardiovascular events and multiple vascular risk factors. However, whether the process is associated with increased carotid atherosclerotic plaque per se or not is still unclear.
Nine hundred and forty-two participants aged from 46 to 75 were enrolled from community population in Southern China. Their metabolic risk factors, carotid intima-media thickness (cIMT) and atherosclerotic plaque formation were analyzed and stratified by different blood pressure levels according to JNC-7 or ESH/ESC-2007 classification.
From low BP level to higher BP level, multiple metabolic risk factors increased linearly. Prehypertension in JNC-7 classification (or normal BP and high normal BP in ESH/ESC-2007 classification) was correlated with thicker cIMT and more plaque formation than normotension (or optimal BP) (p < 0.001). After adjusting multiple metabolic factors, the differences were still significant (p < 0.05). Furthermore, prehypertensive participants had a trend to be thicker carotid IMT (OR and its 95% CI: 1.65, 0.97-2.82, p = 0.067) and significantly higher carotid plaque occurrence (OR and its 95% CI: 2.36, 1.43-3.88, p = 0.001) than normotensive ones. However, there was no significant difference of cIMT and plaque formation between normal BP and high normal BP (p > 0.05). Plaque formation in prehypertension was as significant as that in hypertension.
Prehypertension is associated with significantly increased carotid atherosclerotic plaque and is a primary stratify risk factor for carotid atherosclerosis which could cause ischemic stroke in middle-aged and elderly population in Southern China.
从正常血压水平升高到高血压的过程与心血管事件和多种血管危险因素的增加有关。然而，这一过程是否与颈动脉粥样硬化斑块本身的增加有关尚不清楚。
本研究共纳入了 942 名年龄在 46 至 75 岁之间的来自中国南方社区人群的参与者。根据 JNC-7 或 ESH/ESC-2007 分类标准，分析了他们的代谢危险因素、颈动脉内膜中层厚度（cIMT）和粥样硬化斑块形成情况，并按不同血压水平进行分层。
从低血压水平到更高的血压水平，多种代谢危险因素呈线性增加。JNC-7 分类中的高血压前期（ESH/ESC-2007 分类中的正常血压和正常高值血压）与正常血压（或最佳血压）相比，cIMT 更厚，斑块形成更多（p < 0.001）。调整多种代谢因素后，差异仍然显著（p < 0.05）。此外，高血压前期患者颈动脉 IMT 更厚的趋势（OR 及其 95%CI：1.65，0.97-2.82，p = 0.067）和颈动脉斑块发生率显著更高（OR 及其 95%CI：2.36，1.43-3.88，p = 0.001），高于正常血压患者。然而，正常血压和正常高值血压之间的 cIMT 和斑块形成无显著差异（p > 0.05）。高血压前期的斑块形成与高血压一样显著。
高血压前期与颈动脉粥样硬化斑块明显增加有关，是导致中国南方中老年人群发生缺血性脑卒中的主要分层危险因素。
