OBJECTIVETo analyze the associations of blood pressure (BP) level with carotid intima-media thickness (CIMT) and plaque in a middle-aged and elderly hypertensive population.

METHODSBy block randomized sampling, an epidemiological investigation was conducted among hypertensives aged 45 - 75 years in the northern rural area of Jiangsu Province. Blood pressure was measured, and carotid CIMT and plaque were determined using a coloured ultrasonograph. The relationship between blood pressure level and CIMT or plaque was analyzed using a multivariable linear regression or logistic regression model.

RESULTSA total of 524 subjects (male 242) were enrolled. CIMT and plaque prevalence were (0.7 ± 0.1) mm and 46.3% in males and (0.7 ± 0.1) mm and 34.0% in females. After adjustment for relevant variables, CIMT increased 0.001 12 mm with 1 mmHg systolic BP increase in males (P < 0.001) but this trend was not significant in females. The risk of plaque number > 1 was significantly higher in those with grade III hypertension compared to grade I hypertensives (OR: 2.136, 95%CI: 1.138 - 4.012, P = 0.018).

CONCLUSIONIn this middle-aged and elderly hypertensive population, carotid CIMT is positively in relation to systolic BP, especially for male patients. Higher BP is associated with higher risk of plaque occurrence. Hypertension is thus an independent risk factor for the formation of atherosclerosis.