Gariepy J, Simon A, Massonneau M, Linhart A, Segond P, Levenson J
Centre de Médecine Préventive Cardiovasculaire and Unité INSERM U28, Broussais Hospital, Paris, France.
Am J Hypertens. 1996 Feb;9(2):126-36. doi: 10.1016/0895-7061(95)00262-6.
Extracoronary in vivo structural arterial changes were studied in asymptomatic essential hypertension. Carotid and femoral arteries were examined with B-mode echography for the presence or absence of plaque (the whole vascular segments of each vessel in the both sides) and for automated measurement of the far wall intima-media thickness (the vascular segment of each vessel proximal to the bifurcation in the right side) in 53 never treated hypertensive men and 133 normotensive men similar with regard to age, serum cholesterol levels, and smoking history. In the hypertensive group carotid plaque was more frequent (P < .05) and carotid and femoral intima-media thicknesses were greater (P < .001) than in the normotensive group. In the overall normotensive and hypertensive population intima-media thickness was independently associated with age and systolic pressure in both arteries (P < .001) and with cholesterol in the femoral artery (P < .05) while plaque was associated with systolic pressure (P < .01), and cholesterol (P < .01) in the carotid arteries and with age (P < .01), cholesterol (P < .05), and smoking (P < .001) in the femoral arteries. No significant difference in intima-media thickness in both arteries existed between hypertensive subjects with plaque and those without. Wall thickening and plaque were more frequent in hypertensive patients. Thickening was distributed homogeneously to both arteries, while plaque affected preferentially the femoral bed. The influence of age and pressure was more marked on intima-media thickness than on plaque. The lack of association between wall thickening and plaque suggested that vascular hypertrophy and early atherosis might be two different structural changes.
在无症状原发性高血压患者中研究了冠状动脉外的体内动脉结构变化。对53名未经治疗的高血压男性和133名在年龄、血清胆固醇水平和吸烟史方面相似的血压正常男性，用B型超声检查颈动脉和股动脉，以确定是否存在斑块（双侧每条血管的整个血管段），并自动测量远壁内膜中层厚度（右侧每条血管靠近分叉处的血管段）。与血压正常组相比，高血压组颈动脉斑块更常见（P<0.05），颈动脉和股动脉内膜中层厚度更大（P<0.001）。在整个血压正常和高血压人群中，内膜中层厚度与两条动脉的年龄和收缩压均独立相关（P<0.001），与股动脉中的胆固醇相关（P<0.05），而斑块与颈动脉中的收缩压（P<0.01）和胆固醇（P<0.01）以及股动脉中的年龄（P<0.01）、胆固醇（P<0.05）和吸烟（P<0.001）相关。有斑块和无斑块的高血压受试者在两条动脉的内膜中层厚度上无显著差异。高血压患者中血管壁增厚和斑块更常见。增厚在两条动脉中均匀分布，而斑块优先影响股动脉床。年龄和血压对内膜中层厚度的影响比对斑块的影响更明显。血管壁增厚与斑块之间缺乏关联表明血管肥大和早期动脉粥样硬化可能是两种不同的结构变化。
