The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
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The change in carotid intima-media thickness in prehypertensive adults

Prehypertension 성인에서 경동맥 내막-중막 두께의 변화

Kim, Sung-Jin;Jung, Kap-Sung;Lee, Kwang-Ho;Choi, Soo-Hee;Lee, Kyung-Eun;Lee, Sung-Ho;Lee, Kwang-Je;Kim, Sang-Wook;Kim, Tae-Ho;Kim, Chee-Jeong;Ryu, Wang-Seong
김성진;정갑성;이광호;최수희;이경은;이성호;이광제;김상욱;김태호;김치정;류왕성

  • Published : 20060200
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Abstract

Background: Prehypertension is a precursor of clinical hypertension and tends to increase in severity over time. Structural vascular changes have not been much investigated in adults with prehypertension. Methods: We investigated the carotid intima-media thickness (IMT) in prehypertensive adults, pharmacologically untreated, compared with normotensive and hypertensive patients. Mean and maximum carotid IMT were obtained from six far walls of the common carotid, the bifurcation, and the internal carotid artery on both sides of the neck with high-resolution B-mode ultrasonography. Results: Mean IMT was largest in the carotid bifurcation, followed by the common carotid and the internal carotid artery in all groups. Hypertensives had higher mean IMT values at all locations than normotensive controls. In prehypertensive adults, the mean and maximum IMT values were significantly higher than in normotensive controls. In contrast, there was no significant difference in the mean and maximum carotid IMT between prehypertensive adults and patients with stage 1 hypertension. The prevalence of plaques was 15.7% in prehypertensive adults, compared with 4.4% in controls, 22.2% in stage 1 hypertensives, and 29.4% in stage 2 hypertensives. Conclusions: Prehypertensive adults had thicker mean carotid IMT than normotensive controls and exhibited similarly abnormal carotid structure as the patients with stage 1 hypertension. These results suggest we need the continuous evaluation for early clinical detection and intervention of prehypertension.

목적 : Prehypertension은 임상적 고혈압의 전단계로 간주되고 있으며 시간이 경과할수록 혈압의 상승이 진행되어 상당수가 고혈압으로 이행하는 것으로 알려져 있다. 본 연구는 prehypertension군의 혈관에 구조적 변화가 나타나는지 알아보기 위하여 경동맥 내막-중막 두께를 평가하여 보았다. 방법 : 순환기 질환을 앓은 기왕력이 없는 prehypertension 성인(51명)과 정상혈압군(45명), stage 1 고혈압군(45명), stage 2 고혈압군(85명)을 대상으로 고해상도 B-mode 초음파를 이용해서 좌,우 총경동맥, 경동맥 분지위치 및 내경동맥 원벽 6부위에서 내막-중막 두께를 측정하여 비교하였다. 결과 : 네 군 모두에서 내막-중막의 두께가 가장 두꺼워진 위치는 경동맥 분지 위치였으며, 다음에는 총경동맥, 내경동맥의 순이었다. Prehypertension 성인 경동맥 6부위 평균 내막-중막 두께는 정상 혈압군에 비해서 약 20% 증가하였다. 경동맥 최대 내막-중막 두께는 prehypertension군이 평균 0.97 mm로서 정상 혈압군의 0.70 mm보다 유의하게 두꺼웠으며(p<0.05), stage 1 고혈압군(1.13 mm)과는 유의한 차이가 없었고, stage 2 고혈압군(1.26 mm)보다는 낮게 나타났다. 경동맥 죽상반의 유병율은 정상 혈압군에서 4.4%, prehypertension군 15.7%, stage 1 고혈압군 22.2%, stage 2 고혈압군에서 29.4%로 나타났다. 결론 : Prehypertension 성인의 경동맥 내막-중막 두께는 정상혈압군보다 유의하게 두꺼웠으며 오히려 stage 1 고혈압군에 가까운 변화를 보여주었다. 향후 prehypertension 성인을 조기 발견해서 심혈관 합병증에 대한 적절한 예방 및 치료가 필요할 것으로 사료된다.

Keywords

References

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