Simon A, Levenson J
Centre de Médecine Préventive Cardio-Vasculaire Hôpital Broussais, Paris.
Clin Exp Hypertens. 1993 Nov;15(6):1069-76. doi: 10.3109/10641969309037094.
Subclinical atherosclerosis can be non-invasively detected via calcifications, thickening and stiffening of arteries. Coronary calcifications seen with ultrafast computed tomography are frequent in hypertension or hypercholesterolemia and synonymous of coronary atherosis but not of coronary stenosis. Wall thickening detectable by extracoronary ultrasonography may be characterized by an intimamedia thickening shown in hypertension or by a focalized plaque whose the presence in the aortic or femoral level seem influenced by systolic pressure. Extracoronary wall thickening may be an aid in the diagnosis of coronary atherosclerosis, a predictor of coronary event, and a therapeutic target. Wall stiffening, which reflects sclerosis, is detected by pulse wave velocity. Its increase in hypertension may be an indicator of atherosclerosis and can be reversed by certain antihypertensive agents. Clinical care of at risk individuals might profit from subclinical atherosclerosis which adds objectivity and sensitivity in the individualization of risk and the decision to treat.
亚临床动脉粥样硬化可通过动脉钙化、增厚和硬化进行无创检测。通过超速计算机断层扫描发现的冠状动脉钙化在高血压或高胆固醇血症中很常见，是冠状动脉粥样硬化的同义词，但不是冠状动脉狭窄的同义词。冠状动脉外超声检查可检测到的血管壁增厚，其特征可能是高血压时出现的内膜中层增厚，或者是主动脉或股动脉水平出现的局灶性斑块，其存在似乎受收缩压影响。冠状动脉外血管壁增厚可能有助于诊断冠状动脉粥样硬化，是冠状动脉事件的预测指标，也是治疗靶点。反映硬化的血管壁僵硬可通过脉搏波速度检测。高血压时其升高可能是动脉粥样硬化的指标，某些降压药物可使其逆转。对高危个体的临床护理可能受益于亚临床动脉粥样硬化，它在风险个体化和治疗决策中增加了客观性和敏感性。
