RESUMO
@#BACKGROUND:The purpose of this study was to use point-of-care ultrasound (POCUS) to investigate the relationship between tobacco smoke exposure and the characteristics of the common carotid artery (CCA). The effect of both primary and secondary smoking on CCA properties was evaluated. METHODS:We performed a prospective cross-sectional study across 20 primary care clinics in Bandung, West Java, Indonesia in July 2016. Point of care ultrasound was performed on a convenience sample of Indonesian patients presenting to clinic. The CCA wall stiffness and carotid intima-media thickness (CIMT) were measured during diastole and systole. These measurements were correlated with smoke exposure and cardiovascular disease. RESULTS: We enrolled 663 patients in the study, with 426 patients enrolled in the smoking category and 237 patients enrolled in the second-hand smoke category. There was an overall positive correlation with the measured lifestyle factors and the ultrasound-measured variables in the group of individuals who smoked. For all variables, age seemed to contribute the most out of all of the lifestyle factors for the positive changes in CIMT and CCA wall stiffness. CONCLUSION:Our data yielded correlations between CCA properties and cardiovascular risk, as well as between CIMT and arterial stiffness. We were also able to demonstrate an increase in thickness of the CIMT in patients who have been exposed by tobacco through the use of ultrasound. Further large scale studies comparing patients with multiple cardiac risk factors need to be performed to confirm the utility of ultrasound findings of cardiovascular disease and stroke.
RESUMO
Background: Cholesterol lowering drugs are very widely used among patients with hypertension in order to prevent atherosclerosis and death. However several other changes are produced in such patients as a result of inhibition of cholesterol synthesis. Therefore in this preliminary study we evaluated the intima/media thickness in hypertensive subjects. Material and methods: Cross section study in 20 hypertensive subjects on statins for more than an year and 20 hypertensives who were not on statins were studied. Twenty normal non hypertensive individuals were control subjects.Their Common carotid artery (CCA) was ultrasonologically examined and the Intima – Media thickness were determined. Results: The Intima - Media thickness in Hypertensive subjects were significantly higher than those of control groupand also those hypertensive patients who were administered with statins (p<0.001). There was no statistically significant difference among the controls and statin administered patients. Further there was no gender difference in the results. Conclusion: Hypertensive subjects who were on statin for more than an year have significantly reduced arterial wall thickness. Undesirable side effects of such thinning of vessel wall, which might result in aneurysmal dilatations, should be kept in mind especially while treating elderly hypertensive with HMG CoA reductase inhibitors.