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(Stroke. 2009;40:1515.)
© 2009 American Heart Association, Inc.

Research Letters

Impact of Prehypertension on Common Carotid Artery Intima-Media Thickness and Left Ventricular Mass

Efstathios Manios, MD; Georgios Tsivgoulis, MD, FESO; Eleni Koroboki, MD; Kimon Stamatelopoulos, MD; Christos Papamichael, MD; Savas Toumanidis, MD; Elefterios Stamboulis, MD; Konstantinos Vemmos, MD Nikolaos Zakopoulos, MD

From the Department of Clinical Therapeutics (E.M., E.K., K.S., C.P., S.T., K.V., N.Z.), University of Athens School of Medicine, Alexandra Hospital, and the Second Department of Neurology (G.T., E.S.), University of Athens School of Medicine, Attikon Hospital, Athens, Greece.

Correspondence to Dr Georgios Tsivgoulis, Attikon Hospital, Second Department of Neurology, University of Athens School of Medicine, Iras 39, 15344, Athens, Greece. E-mail tsivgoulisgiorg{at}yahoo.gr

Background and Purpose— Prehypertension has been recently introduced by JNC 7 as a new blood pressure (BP) category, associated with increased target-organ damage. Subclinical atherosclerosis by means of common artery intima-media thickness (CCA-IMT) has been incompletely investigated in prehypertensive patients. The aim of our study was to assess the extent of CCA-IMT and left ventricular mass (LVM) in prehypertensive adults in comparison to normotensive and untreated hypertensive subjects.

Methods— From a total of 5221 consecutive patients screened to our Hypertension Unit we selected 896 consecutive individuals according to prespecified inclusion criteria, who underwent 24-hour ambulatory BP monitoring, carotid artery ultrasonographic, and echocardiographic measurements. Patients who received antihypertensive treatment during the BP monitoring were excluded. According to the office BP levels, patients were divided into 3 subgroups: normotensives (office BP <120/80 mm Hg), prehypertensives (120/80 mm Hgoffice BP<140/90 mm Hg), and hypertensives (office BP 140/90 mm Hg). Statistical analyses were performed by means of 1-way ANOVA, ² test, and ANCOVA.

Results— According to the office BP levels, the distribution of the study population was: normotensives (14.4%), prehypertensives (23.7%), and hypertensives (61.9%). Prehypertensive patients had higher CCA-IMT (P=0.038) and LVM (P=0.030) values than normotensive subjects, even after adjustment for baseline characteristics. Greater CCA-IMT values were observed in hypertensive patients in comparison to prehypertensives (P=0.002).

Conclusions— Prehypertensive patients had higher CCA-IMT and LVM than their normotensive counterparts. Prehypertension status is cross-sectionally associated with subclinical atherosclerosis and target-organ damage.

Key Words: prehypertension • common carotid artery intima-media thickness • left ventricular mass

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