Stroke, Vol 24, 355-361, Copyright © 1993 by American Heart Association
K Sutton-Tyrrell, HG Alcorn, SK Wolfson Jr, SF Kelsey and LH Kuller
BACKGROUND AND PURPOSE: This study was designed to determine the prevalence
of carotid stenosis and atherosclerosis in older adults with and without
isolated systolic hypertension and to determine risk factors for carotid
artery disease in these two groups. METHODS: Duplex scans were performed on
187 participants of the Systolic Hypertension in the Elderly Program and on
187 normotensive control subjects. Doppler measures of blood flow velocity
were used to determine the prevalence of internal carotid artery stenosis.
RESULTS: Carotid stenosis was found in 25% of hypertensive participants but
in only 7% of normotensive participants (p < 0.001). Among hypertensive
participants, carotid stenosis was correlated with lower diastolic blood
pressure (p = 0.022). In multivariate analysis, systolic blood pressure of
> or = 160 mm Hg was the strongest predictor of carotid stenosis. Other
variables independently related to stenosis were diastolic blood pressure
of < 75 mm Hg (p = 0.001), alcohol use (p = 0.005), heart rate of >
or = 80 beats per minute (p = 0.013), smoking (p = 0.034), high
concentration of apoprotein B (p = 0.001), and low concentration of high
density lipoprotein cholesterol (borderline significant, p = 0.069). Among
hypertensive participants, the strongest predictor of carotid stenosis was
low diastolic blood pressure. This relation persisted even after taking
into account differences in pulse pressure. CONCLUSIONS: Isolated systolic
hypertension is strongly correlated with carotid stenosis, and among those
with isolated systolic hypertension low diastolic blood pressure is a
marker for carotid stenosis.
ARTICLES
Predictors of carotid stenosis in older adults with and without isolated systolic hypertension
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261.
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