Cardiac and vascular hypertrophy in juvenile borderline hypertension: echocardiographic and ultrasonographic study

BACKGROUND. High resolution ultrasonography is a noninvasive technique that allows us to investigate the cardiovascular system, in particular the wall thickness and the lumen diameter of the arteries, with accuracy and reproducibility. METHODS. We measured the intima-media thickness of the common carotid artery (CCA) and of its bifurcation (BIF) in 20 borderline hypertensive (age 24 +/- 4 years) and in 20 normotensive subjects (age 24 +/- 4 years), as a control group. Both carotid axes were scanned from different views (anterior, lateral, posterior) on a transversal and longitudinal section using a high resolution steerable linear array of 5 MHz. Carotid diameter and thickness were measured in the longitudinal section. CCA parameters were assessed 20 mm caudally to the flow divider. RESULTS. In borderline patients blood pressure (147.8 +/- 10.5/90.7 +/- 6.6 mmHg) and left ventricular mass index (102.5 +/- 15.3 g/m2) were significantly higher than in normotensive subjects (blood pressure 120.5 +/- 11.5/78.0 +/- 5.4 mm Hg; left ventricular mass 90.5 +/- 14.3 g/m2). The intima-media thickness of both the CCA and BIF was significantly higher in borderlines than in normotensives (CCA 0.6 +/- 0.08 vs 0.4 +/- 0.05 mm, p < 0.001; BIF 0.7 +/- 0.08 vs 0.5 +/- 0.08, p < 0.001). In the whole population there was a statistically significant correlation between the carotid wall thickness and the left ventricular mass. CONCLUSIONS. Our data show that ultrasonography provides direct evidence that in young borderline hypertensives the increased left ventricular mass is associated with vascular hypertrophy