Baseline Values but Not Treatment-Induced Changes in Carotid Intima-Media Thickness Predict Incident Cardiovascular Events in Treated Hypertensive Patients

• DOI: 10.1161/circulationaha.108.773119
• Publication Date: 2009-09-09T02:19:33Z
• Authors: Alberto Zanchetti; Michael Hennig; Regina Hollweck; Gene Bond; Rong Tang; Cesare Cuspidi; Gianfranco Parati; Rita Facchetti; Giuseppe Mancia
• Keywords: Quartile; Intima-media thickness; Stroke; Baseline (sea)

Baseline carotid intima-media thickness (IMT) and plaques are considered predictors of cardiovascular events, but whether they maintain predictive value in treated hypertensive patients time-related (or treatment-induced) IMT changes additional unknown.Analyses were performed the data from European Lacidipine Study on Atherosclerosis (ELSA), a large, randomized, intervention trial which 2334 7 countries followed up under effective antihypertensive treatment for 3.75 years. Kaplan-Meier curves indicated progressively lower survival free any type outcome except stroke, with increasing baseline quartiles or values, even after adjustment major risk factors. Incidence stroke also was related to number plaques. However, when both on-treatment values entered Cox proportional-hazards models, differences compared did not predict outcomes. Although rather than significantly some IMTs highly correlated, therefore these results inconclusive.ELSA shows that thickening important added risks outcomes population independently blood pressure traditional analysis failed show role treatment-dependent changes. These negative conclusions should be tempered by limitations inherent smallness large individual IMTs.