Prehypertension 성인에서 경동맥 내막-중막 두께의 변화
The change in carotid intima-media thickness in prehypertensive adults
2
조회
0
다운로드
1
인용
0
참고문헌
키워드
초록
목적 : Prehypertension은 임상적 고혈압의 전단계로 간주되고 있으며 시간이 경과할수록 혈압의 상승이 진행되어 상당수가 고혈압으로 이행하는 것으로 알려져 있다. 본 연구는 prehypertension군의 혈관에 구조적 변화가 나타나는지 알아보기 위하여 경동맥 내막-중막 두께를 평가하여 보았다.방법 : 순환기 질환을 앓은 기왕력이 없는 prehypertension 성인(51명)과 정상혈압군(45명), stage 1 고혈압군(45명), stage 2 고혈압군(85명)을 대상으로 고해상도 B-mode 초음파를 이용해서 좌,우 총경동맥, 경동맥 분지위치 및 내경동맥 원벽 6부위에서 내막-중막 두께를 측정하여 비교하였다.결과 : 네 군 모두에서 내막-중막의 두께가 가장 두꺼워진 위치는 경동맥 분지 위치였으며, 다음에는 총경동맥, 내경동맥의 순이었다. Prehypertension 성인 경동맥 6부위 평균 내막-중막 두께는 정상 혈압군에 비해서 약 20% 증가하였다. 경동맥 최대 내막-중막 두께는 prehypertension군이 평균 0.97 mm로서 정상 혈압군의 0.70 mm보다 유의하게 두꺼웠으며(p<0.05), stage 1 고혈압군(1.13 mm)과는 유의한 차이가 없었고, stage 2 고혈압군(1.26 mm)보다는 낮게 나타났다. 경동맥 죽상반의 유병율은 정상 혈압군에서 4.4%, prehypertension군 15.7%, stage 1 고혈압군 22.2%, stage 2 고혈압군에서 29.4%로 나타났다.
Abstract
Background : Prehypertension is a precursor of clinical hypertension and tends to increase in severity over time. Structural vascular changes have not been much investigated in adults with prehypertension. Methods : We investigated the carotid intima-media thickness (IMT) in prehypertensive adults, pharmacologically untreated, compared with normotensive and hypertensive patients. Mean and maximum carotid IMT were obtained from six far walls of the common carotid, the bifurcation, and the internal carotid artery on both sides of the neck with high-resolution B-mode ultrasonography. Results : Mean IMT was largest in the carotid bifurcation, followed by the common carotid and the internal carotid artery in all groups. Hypertensives had higher mean IMT values at all locations than normotensive controls. In prehypertensive adults, the mean and maximum IMT values were significantly higher than in normotensive controls. In contrast, there was no significant difference in the mean and maximum carotid IMT between prehypertensive adults and patients with stage 1 hypertension. The prevalence of plaques was 15.7% in prehypertensive adults, compared with 4.4% in controls, 22.2% in stage 1 hypertensives, and 29.4% in stage 2 hypertensives. Conclusion : Prehypertensive adults had thicker mean carotid IMT than normotensive controls and exhibited similarly abnormal carotid structure as the patients with stage 1 hypertension. These results suggest we need the continuous evaluation for early clinical detection and intervention of prehypertension.(Korean J Med 70:165-171, 2006)
참고문헌 (19)
- "Common carotid intima-media thickness and arterial stiffness:indicators of cardiovascular risk in high-risk patients", 100, pp.951~957 (1999)
- "Effects of intensive blood- pressure lowering and low-dose aspirin in patients with hypertension: principal result of the Hypertension Optimal Treatment (HOT) randomized trial", 351, pp.1755~1762 (1998)
- "The seventh report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure: the JNC 7 report", 289, pp.2560~2572 (2003)
- "Sonographic evaluation of carotid artery atherocslerosis in the eldery:relationship of disease severity to stroke and transient ischemic attack", 188, pp.363~370 (1993)
- "Risk factors related to the wall thickness of the common carotid artery in elderly patients", 33, pp.835~839 (1996)
- "Carotid artery intima-media thickness as a risk factor for myocardial infarction and stroke in older adult", 340, pp.14~22 (1999)
- "Carotid arterial structure in patients with documented coronary artery disease:free control subjects", 107, pp.1146~1151 (2003)
- "관상동맥 질환의 선별검사로서의 경동맥 내중막 두께", 35, pp.460~466 (2005)
- "관상동맥질환의 중등도 예측을 위한 총 경동맥 B-Mode 초음파의 임상적의의 수동 측정상의 중요인자들", 35, pp.467~473 (2005)
- "Echocardiographic assessment of left ventricular hypertrophy:comparison to necrosy findings", 57, pp.450~458 (1986)
- "Differential association of commom carotid intima-media thickness and carotid atherosclerotic plaques with parental history of premature death from coronary heart disease", 19, pp.366~371 (1999)
- "Carotid intima-media thickness and plaque characteristics as a risk factor for stroke in Japanese eldery men", 35, pp.2788~2794 (2004)
- "Prevalence of hypertensive in the US adult populations: results from the third National Health and Nutritional Examination Survey 1988-1991", 25, pp.305~313 (1995)
- "Residual lifetime risk for developing hypertension in middle-aged women and men", 287, pp.1003~1010 (2002)
- "Factors underlying the increased in carotid intima-media thickness in borderline hypertensives", 19, pp.1231~1237 (1999)
- "Validity and reproducibility of color enhancement of B-mode ultrasound images of for wall thickness of the common carotid artery", 9, pp.549~555 (1996)
- "Incidence of carotid artery atherosclerosis in patients with coronary disease", 44, pp.34~38 (1993)
- "Role of prehypertension in the department of coronary atherosclerosis in Japan.", 14, pp.57~62 (2004)
- "Elevation of C-reactive protein in people with prehypertension", 6, pp.562~568 (2004)