Vol 7, No 4 (2003)
Original paper
Published online: 2003-09-24

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Atherosclerotic Plaque Morphology in Patients with Hypertension

Elena Weber, Iwona Dębicka, Jacek Kubica, Maria Bogdan, Marek Radomski, Adam Sukiennik, Marcin Rychter, Anna Jachalska, Grzegorz Raczak, Dariusz Kozłowski, Mirosław Jabłoński, Anna Kowalska, Tomasz Białoszyński
Nadciśnienie tętnicze 2003;7(4):263-270.

Abstract

Background The aim of the study was to determine the influence of hypertension on atherosclerotic plaque morphology in patients with coronary heart disease.
Material and methods The study was performed on 30 men and 8 women aged from 35 to 75 years (mean age 60 years). Plaque morphology was evaluated by means of intracoronary ultrasound. For all the patients, demographic data and data concerning selected risk factors of arteriosclerotic disease: hypercholesterolemia, hypertension, diabetes mellitus type 2 and smoking had been collected. Morphology and size of plaques were analyzed in cross-sections of coronary arteries. 63 atherosclerotic plaques in hypertensive patients and 96 plaques in normotensive patients were analyzed. Plaques were classified as: soft, mixed and hard - based on echointensity, with or without calcification, concentric and eccentric. The cross-sections were divided into 3 groups according to severity of lumen reduction: < 50% (I group), 50–75% (II group) and ≥ 75% (III group).
Results Mixed and hard plaques were observed significantly more frequently in hypertensive patients (70%, including mixed plaques - 57%, hard plaques - 13%) than in normotensive patients (45%, including mixed plaques - 38%, hard plaques - 7%) (p = 0.002). Comparing plaque structure in 3 groups of the cross-sections with different severity of lumen reduction, only in group I (< 50%) soft plaques occurred more rarely in hypertensive than normotensive patients (p = 0.0018). There were no significant differences in group II and III. No statistical differences were obtained for the occurrence of calcification and plaque distribution in hypertensive patients compared to normotensive patients.
Conclusions Hard and mixed plaques occurred more frequently in hypertensive in comparison to normotensive patients. These data suggest that hypertension may be a factor that combined with other risk factors, influences other course of atherosclerosis in coronary arteries.

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