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Abstract

To assess the relation between changes in the carotid arterial wall, blood pressure (BP) values and stroke we studied 140 consecutive patients with stroke (confirmed on CT scan). On admission blood pressure, ECG and carotids ultrasound imaging in standard points were assessed in order to evaluate the presence of intima-media thickness (IMT) (until 1.5 mm) and atheromatous plaques (AP) (above 1.5 mm). Also were evaluated, after 12 hrs fasting period of initial symptoms, plasma uric acid, cholesterol, triglycerides, HDL-C and Lp(a). The patients sample was divided in three groups according to ultrasound carotid image, normal carotid (group A), carotid with IMT (group B) and carotid with AP (group C). The table shows the results (mean±SEM) obtained and analyzed by ANOVA and, for those expressed as percentage values, by the X2 method.

Group AGroup BGroup C
Patients24 (15 male)62 (36 male)54 (42 male)
Age (yrs)61.25 ± 2.3 $ *70.1 ± 0.971.7 ± 0.9
SBP (mmHg)174.3 ± 2.3 $ *160.0 ± 2.7160.3 ± 2.7
DBP (mmHg)98.3 ± 2.5 $ *92.3 ± 1.289.9 ± 1.5
Total Cholest. mg/dl186 ± 6.8 *211.1 ± 2.3 §232.5 ± 5.8
Lp(a) mg/dl24 ± 4.1 $44 ± 4.1 §34 ± 5.2
CT scan Ische8 (33%) $ *50 (81%)48 (89%)
Hemor16 (67%) $ *12 (19%)6 (11%)
Group AGroup BGroup C
Patients24 (15 male)62 (36 male)54 (42 male)
Age (yrs)61.25 ± 2.3 $ *70.1 ± 0.971.7 ± 0.9
SBP (mmHg)174.3 ± 2.3 $ *160.0 ± 2.7160.3 ± 2.7
DBP (mmHg)98.3 ± 2.5 $ *92.3 ± 1.289.9 ± 1.5
Total Cholest. mg/dl186 ± 6.8 *211.1 ± 2.3 §232.5 ± 5.8
Lp(a) mg/dl24 ± 4.1 $44 ± 4.1 §34 ± 5.2
CT scan Ische8 (33%) $ *50 (81%)48 (89%)
Hemor16 (67%) $ *12 (19%)6 (11%)

P<0.05 = $ A vs B,

*

A vs C

§

B vs C

Group AGroup BGroup C
Patients24 (15 male)62 (36 male)54 (42 male)
Age (yrs)61.25 ± 2.3 $ *70.1 ± 0.971.7 ± 0.9
SBP (mmHg)174.3 ± 2.3 $ *160.0 ± 2.7160.3 ± 2.7
DBP (mmHg)98.3 ± 2.5 $ *92.3 ± 1.289.9 ± 1.5
Total Cholest. mg/dl186 ± 6.8 *211.1 ± 2.3 §232.5 ± 5.8
Lp(a) mg/dl24 ± 4.1 $44 ± 4.1 §34 ± 5.2
CT scan Ische8 (33%) $ *50 (81%)48 (89%)
Hemor16 (67%) $ *12 (19%)6 (11%)
Group AGroup BGroup C
Patients24 (15 male)62 (36 male)54 (42 male)
Age (yrs)61.25 ± 2.3 $ *70.1 ± 0.971.7 ± 0.9
SBP (mmHg)174.3 ± 2.3 $ *160.0 ± 2.7160.3 ± 2.7
DBP (mmHg)98.3 ± 2.5 $ *92.3 ± 1.289.9 ± 1.5
Total Cholest. mg/dl186 ± 6.8 *211.1 ± 2.3 §232.5 ± 5.8
Lp(a) mg/dl24 ± 4.1 $44 ± 4.1 §34 ± 5.2
CT scan Ische8 (33%) $ *50 (81%)48 (89%)
Hemor16 (67%) $ *12 (19%)6 (11%)

P<0.05 = $ A vs B,

*

A vs C

§

B vs C

In the group A the stroke is prevalent hemorrhagic, it is significantly related with more elevated BP values respect to groups B and C and also it occurs in more young pts. In the group C there is an high incidence of ischemic stroke related to significant elevated cholesterol levels. In the group B the Lp(a) values are significantly more elevated than the other groups.

Our data suggest than, in stroke pts, when cholesterol level is increased, atherosclerotic lesions responsible for ischemic cerebral disease, may represent the main risk factor; while, when cholesterol levels are normal, hypertension may be considered the mayor factor responsible for stroke, particularly the hemorrhagic one. Also, when Lp(a) concentration is increased can represent an early marker of carotid damage.

Stroke, Hypertension, Vascular injury
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© American Journal of Hypertension, Ltd. 2001
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