Document Detail


Pulse pressure is independently associated with carotid plaque ulceration.
MedLine Citation:
PMID:  12923399     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Plaque rupture is the principal cause of acute coronary ischaemia, and unstable carotid plaques are associated with a high risk of ischaemic stroke. Carotid plaque ulceration also predicts acute coronary events, suggesting that systemic factors may determine plaque instability. One potentially important factor is pulse pressure. There is indirect evidence that cyclical haemodynamic forces affect plaque stability, and pulse pressure is a strong predictor of coronary events. OBJECTIVE: To study the association between pulse pressure and plaque ulceration. DESIGN AND METHODS: We studied angiograms from 3007 patients with recently symptomatic carotid stenosis in the European Carotid Surgery Trial. Presence of ulceration was related to the different components of blood pressure [pulse pressure, systolic blood pressure (SBP), mean arterial pressure (MAP), and diastolic blood pressure (DBP)], and adjustment was made for age, sex, diabetes, smoking, and the degree of vessel stenosis. RESULTS: Pulse pressure was the strongest independent predictor of ulceration of the symptomatic carotid plaque [adjusted odds ratio (OR) for the upper compared with the lower quintile 2.07, 95% confidence interval (CI) 1.25 to 3.44; P = 0.004]. This relationship was weaker for SBP (OR 1.66, 95% CI 1.05 to 2.62; P = 0.02), and non-significant for MAP (OR 1.58, 95% CI 1.01 to 2.48, P = 0.13) and DBP (OR 1.67, 95% CI 0.73 to 1.87, P = 0.50). CONCLUSIONS: Pulse pressure is independently associated with carotid plaque ulceration, supporting the hypothesis that pulsatile haemodynamic forces are an important cause of plaque rupture.
Authors:
Joanna K Lovett; Sally C Howard; Peter M Rothwell
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of hypertension     Volume:  21     ISSN:  0263-6352     ISO Abbreviation:  J. Hypertens.     Publication Date:  2003 Sep 
Date Detail:
Created Date:  2003-08-18     Completed Date:  2003-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1669-76     Citation Subset:  IM    
Affiliation:
Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Blood Pressure*
Carotid Stenosis / mortality*,  pathology*,  surgery
Cerebral Angiography
Female
Follow-Up Studies
Humans
Male
Middle Aged
Predictive Value of Tests
Risk Factors
Rupture

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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