Intima-media thickness of femoral arteries and carotids among an adult hypertensive Nigerian population: a case­control study to assess their use as surrogate markers of atherosclerosis

Background: Increased intima-media thickness (IMT) is an established and important surrogate marker for atherosclerosis. Intima-media thickening in the femoral arteries occur earlier and reflect the true extent of generalized atherosclerosis better than in the carotids. Aims: To study the ultrasound-detected morphological changes in the common femoral versus carotid artery wall. Patients and Methods: A case-control study design was used, with 61 adult hypertensive as cases and 61 age-, sex- and BMI-matched normotensive as controls. Variables were participants' characteristics, cardiovascular risk factors, and ultrasonographically evaluated IMT of the carotid and femoral arteries. Results: A total of 122 participants were studied. The mean femoral IMT in hypertensives and controls on the right and left was 0.63 ± 0.07mm vs. 0.52 ± 0.06mm [P < 0.0001] and 0.69 ± 0.0 mm vs. 0.55 ± 0.05mm [P < 0.0001]. Also, the mean carotid IMT among hypertensives and controls on the right =0.80 ±0.15mm vs. 0.64 ± 0.06mm [P < 0.0001], and 0.91 ± 0.22mm vs. 0.65 ± 0.06mm [P < 0.0001] on the left. Significant correlation was observed between IMT and age (B = 0.006, P < 0.001 and B = 0.003, P < 0.001), hypertension (B = 0.205, P < 0.001 and B = 0.122, p<0.001), and duration of hypertension (B = 0.02, P < 0.001 and B = 0.006, P = 0.02) the femoral and carotid arteries respectively. Conclusion: The femoral and the carotid artery show similar significantly increased IMT in hypertensive adults. The femoral IMT appears to be a good surrogate marker of atherosclerosis among hypertensive Nigerians

Comparative evaluation of carotid intima media thickness in paediatric type 1 diabetic children and healthy children in Ibadan and Lagos, Nigeria

Patients with type 1 diabetes are at greater risk of cardiovascular disease and atherosclerosis. Carotid in-tima­media thickness (CIMT) measured by ultrasound is a marker of atherosclerosis and can predict future cardiovascular events.The aim of this study was to measure the CIMT in paediatric type 1 diabetes patients in Ibadan and Lagos and compare results with the CIMT of non-diabetic healthy control children. Carotid ultrasound was performed and CIMT measured in 70 subjects (35 diabetic patients and 35 non-diabetic controls matched for age and sex). Mean age was 12.8±3.2 years. A slightly higher, but non-significant mean CIMT was seen in diabetic cases: mean values in type 1 diabetes patients were 0.475±0.068 and 0.476±0.069 (right and left respectively) while in controls, mean values were 0.467±0.064 and 0.468±0.054 (p=0.618 and 0.575 respectively). The CIMT in both groups correlated positively with age and body mass index (BMI). Significantly higher mean CIMT values were seen in males with type 1 diabetes on both sides. However, there was no significant correlation between CIMT and duration of illness, insulin dosage, or blood pressure. CIMT is a safe and convenient measurement, which may be helpful in predicting an increased risk of future cardiovascular disease in children with type 1 diabetes

Increased Carotid Intima-Media Thickness and Associated Risk Factors among Congolese Hypertensive Patients in Kinshasa. A Cross-Sectional Study

Objective. To assess the prevalence of increase carotid Intima-media thickness and associated risk factors in hypertensive patients. Methods. 60 consecutive hypertensive patients ( 45 years) seen at the outpatient hypertension Clinic were included in the present study. They underwent the following procedures: (i) medical history; physical examination and clinic blood pressure measurement; (ii) routine blood chemistry; (iii) carotid B mode ultrasound. Increased carotid IMT was defined as values 0.9 mm and 1.3 mm or values 75th percentile. 2007 ESH/ESC guidelines were used to assess cardiovascular risk. Univariate logistic regression analysis was used to evaluate risk factors associated with increased cIMT. P value 0.05 defined the level of statistical significance. Results. Increased IMT was present in 12and 32of patients using values 0.9 mm and 0.8 (75th percentile); respectively. Age 60 years (OR: 7.5; 95CI: 1.9-30; p = 0.003); diabetes 5 years (OR: 2.0; 95CI: 1.1-3.7; p = 0.016); hypertension 7 years (OR: 3.6; 95CI: 1.1-13; p = 0.029) and uric acid 7 mg/dl (OR: 4.6; 95CI: 1.4-15; p = 0.012) emerged as the main predictors of the risk of having increased cIMT. Conclusion. Increased IMT was common among the present case series; diabetes; hypertension and hyperuricemia; all components of the MetS; emerged as the main modifiable risk factors associated with increased cIMT. Therapeutic lifestyle changes should be encouraged in addition to antihypertensive therapy in these patients