Department of Neurology and psychiatry, Faculty of Medicine, Assiut University, Assiut, Egypt.
Neurosciences (Riyadh). 2020 Oct;25(5):386-391. doi: 10.17712/nsj.2020.5.20200034.
The prevalence of atherosclerosis in extracranial vessels among hypertensive patients in southern Egypt is still unknown. Carotid ultrasound is an accurate method used to identify and follow patients with cerebrovascular disorders. The aim of our study is to detect the prevalence and pattern of extracranial atherosclerosis among those patients.
Our case-control study was performed from January 2017 to January 2018, including 200 subjects, 100 patients recruited consecutively from the Hypertension Clinic in Assiut University hospitals, Egypt, and 100 healthy controls. Detailed history collection and thorough physical examinations were carried out for each patient. All subjects underwent extracranial ultrasound. We omitted patients with history of ischemic stroke and TIAs.
The presence of increased intima media thickness was detected in 37 patients (37%). 22 patients (22%) had internal carotid artery (ICA) stenosis, 17 patients (17%) had non-significant stenosis <50%, while five patients (5%) had stenosis 50-69%. 9% had stenosis < 50% in vertebral artery. In addition, age and uncontrolled hypertension have a greater impact on increasing the CCA intima media thickness, which is considered an early sign of atherosclerosis.
Uncontrolled hypertension is an important risk factor for atherosclerosis and hence ischemic stroke (IS). The cost of screening is considered low compared to IS management. Greater emphasis should be directed toward regular screening programs in this risky population.
埃及南部高血压患者颅外血管粥样硬化的患病率尚不清楚。颈动脉超声是一种用于识别和随访脑血管疾病患者的准确方法。我们研究的目的是检测这些患者颅外动脉粥样硬化的患病率和模式。
我们的病例对照研究于 2017 年 1 月至 2018 年 1 月进行,包括 200 名受试者,100 名患者连续从埃及 Assiut 大学医院的高血压诊所招募,100 名健康对照。对每位患者进行详细的病史采集和全面的体格检查。所有受试者均接受颅外超声检查。我们排除了有缺血性卒中和 TIA 病史的患者。
37 名患者(37%)检测到内膜中层厚度增加。22 名患者(22%)存在颈内动脉(ICA)狭窄,17 名患者(17%)存在狭窄<50%,而 5 名患者(5%)狭窄 50-69%。9%的椎动脉狭窄<50%。此外,年龄和未控制的高血压对增加 CCA 内膜中层厚度有更大的影响,这被认为是动脉粥样硬化的早期迹象。
未控制的高血压是动脉粥样硬化和缺血性卒中(IS)的重要危险因素。与 IS 管理相比,筛查的成本被认为较低。应更加重视在这一高危人群中开展定期筛查计划。