[南基伍地区刚果高血压患者的颈动脉内膜中层厚度]

[Carotid intima-media thickness in the Congolese hypertensive in South Kivu].

作者信息

Bianga Katchunga P, Mongane Irenge J, Canwa R, Matabaro A, Nsimire S, Kabunga Q

机构信息

Département de médecine interne, hôpital provincial général de référence de Bukavu, avenue Michombero n(o) 2, BP 285, Bukavu, Sud-Kivu, République démocratique du Congo; Observatoire des maladies non transmissibles, faculté de médecine de l'université catholique de Bukavu, avenue Michombero n(o) 2, BP 285, Bukavu, Sud-Kivu, République démocratique du Congo.

出版信息

Ann Cardiol Angeiol (Paris). 2016 Apr;65(2):64-70. doi: 10.1016/j.ancard.2014.11.001. Epub 2014 Dec 2.

DOI:10.1016/j.ancard.2014.11.001

PMID:25637396

Abstract

OBJECTIVE

The present work aims to establish the frequency, determinants, and the influence of the increased carotid intima-media thickness on the assessment of cardiovascular risk in hypertensive Congolese subjects.

METHODOLOGY

The carotid intima-media thickness was systematically measured using B-mode ultrasound in 254 hypertensive patients aged≥25years, all native of South Kivu Province. The association between carotid intima-media thickness and various assumed risk factors was modeled in linear and logistic regressions.

RESULTS

In the entire study population, 28% had an increased carotid intima-media thickness (≥0.9mm) and 22.4% a plaque (>1.2mm). Carotid intima-media thickness was significantly correlated only with age (partial r=0.289, P<0.0001) and duration of hypertension (partial r=0.154, P=0.01). In addition, the increase in carotid intima-media thickness was associated with an increased global cardiovascular risk according to the European and Framingham criteria, respectively, and independently, the risk of stroke [fourth cIMT quartile adjusted OR=5.4 (95% CI: 1.6 to 18.3), P=0.0007]. However, carotid intima-media thickness did not significantly influence the cardiovascular risk categorization (P>0.05).

CONCLUSION

The increase in carotid intima-media thickness in hypertensive Congolese subjects would be a marker of arterial remodeling associated with a long history of uncontrolled hypertension rather than early atherosclerosis. Its systematic detection would pinpoint those at risk of stroke and optimize their treatment.

摘要

目的

本研究旨在确定刚果高血压患者颈动脉内膜中层厚度增加的频率、决定因素及其对心血管风险评估的影响。

方法

采用B型超声对254名年龄≥25岁、来自南基伍省的高血压患者进行颈动脉内膜中层厚度的系统测量。通过线性和逻辑回归分析颈动脉内膜中层厚度与各种假定风险因素之间的关联。

结果

在整个研究人群中，28%的患者颈动脉内膜中层厚度增加（≥0.9mm），22.4%的患者有斑块（>1.2mm）。颈动脉内膜中层厚度仅与年龄（偏相关系数r=0.289，P<0.0001）和高血压病程（偏相关系数r=0.154，P=0.01）显著相关。此外，根据欧洲和弗明汉标准，颈动脉内膜中层厚度增加分别独立地与全球心血管风险增加以及中风风险相关[第四四分位数调整后的比值比OR=5.4（95%可信区间：1.6至18.3），P=0.0007]。然而，颈动脉内膜中层厚度对心血管风险分类没有显著影响（P>0.05）。