OBJECTIVE: To evaluate the applicability of carotid Doppler echography for the assessment of changes of peripheral hemodynamics in the hypertensives. SUBJECTS: 28 hypertensives (17 males, 11 females), mean age of 64 yrs and 40 normal controls (24 males, 16 females) mean age of 49 yrs. METHODS: We recorded the right common carotid arterial Doppler flow velocity (BFV) pattern and measured the peak velocities of the percussion wave (P) and late rising tidal wave (T), the ratio of the two (P/T), the time interval between the two peaks corrected by heart rate (P-Tc), systolic flow velocity integral (FVI) and carotid artery diameter (CAD) before and after 0.4 mg dose of subligual nitroglycerin (NTG). RESULTS: 1) In hypertensives, the P wave velocity showed lower and P-Tc interval shorter than those of the normal controls at baseline. 2) After NTG, the P-Tc and P/T increased, but the T and FVI decreased significantly in both groups of subjects. 3) The P/T ratio was less significantly increased after NTG in the hypertensives than in the controls. These results suggest that NTG might have been involved in concomitant reduction and delay of the wave reflection from the peripheral vessels, preferentially in the normal subjects than in hypertensives. CONCLUSIONS: The carotid Doppler echography can be useful for the evaluation of the changes of hemodynamics in the peripheral vessel such as carotid artery in hypertensive subjects.
Administration, Sublingual ; Blood Flow Velocity/drug effects ; Carotid Arteries/ultrasonography ; Carotid Arteries/drug effects ; Case-Control Studies ; Female ; Human ; Hypertension/ultrasonography ; Hypertension/physiopathology* ; Hypertension/drug therapy* ; Male ; Middle Age ; Nitroglycerin/administration & dosage* ; Ultrasonography, Doppler, Color ; Vasodilator Agents/administration & dosage*

OBJECTIVETo evaluate the effect of blood pressure on vascular endothelial function using echo-tracking (ET) technology.

METHODSThirty hypertensive (HP) patients, 30 subjects with high normal blood pressure (HN), and 30 normotensive control (NC) subjects were enrolled in this study. For each subject, conventional two-dimensional ultrasound was performed to measure the intima-media thickness (IMT), and an ET system was utilized to assess the carotid elasticity (Ep, β, AC, AI, and PWVβ).

RESULTSAs the blood pressure increased, IMT, Ep, β, AI, and PWVβ values all increased and AC value decreased. Before excluding the confounding factors, the difference in IMT, Ep, β, AC, AI, and PWVβ values were significant between the 3 groups. After excluding the confounding factors, only PWVβ value was significantly different between HN group and NC group; but between HP and NC group and between HP and HN group, the other parameters still showed significant differences. Systolic blood pressure had significant influences on IMT, Ep, AC, AI, and PWVβ values, diastolic blood pressure significantly affected AI value, and pulse pressure significantly affected Ep and β values.

CONCLUSIONHigh normal blood pressure has no obvious effects on vascular function, and blood pressure is an independent risk factor of vascular endothelial dysfunction only in the stage of early hypertention. In early atherosclerosis, systolic blood pressure is the most significant factors affecting vascular endothelial function, followed by pulse pressure and diastolic blood pressure.

Adult ; Atherosclerosis ; physiopathology ; Blood Pressure ; physiology ; Carotid Arteries ; diagnostic imaging ; Elasticity ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Hypertension ; complications ; physiopathology ; Male ; Middle Aged ; Ultrasonography

OBJECTIVES: Although risk factors for coronary artery disease are also associated with increased carotid intima-media thickness (IMT), there is little information available on the asymptomatic, young adult population. We examined the association between multiple cardiovascular risk factors and the common carotid IMT in 280 young Korean adults. METHODS: The data used for this study was obtained from 280 subjects (130 men and 150 women) aged 25 years who participated in the Kangwha Study follow-up examination in 2005. We measured cardiovascular risk factors, including anthropometrics, blood pressure, blood chemistry, carotid ultrasonography, and reviewed questionnaires on health behaviors. Risk factors were defined as values above the sex-specific 75th percentile of systolic blood pressure, body mass index, total cholesterol/high-density lipoprotein cholesterol ratio, fasting blood glucose and smoking status. RESULTS: The mean carotid IMT+/-standard deviation observed was 0.683+/-0.079 mm in men and 0.678+/-0.067 mm in women (p=0.567) and the evidence of plaque was not observed in any individuals. Mean carotid IMT increased with an increasing number of risk factors(p for trend <0.001) and carotid IMT values were 0.665 mm, 0.674 mm, 0.686 mm, 0.702 mm, and 0.748 mm for 0, 1, 2, 3, and 4 to 5 risk factors, respectively. The odds ratio for having the top quartile carotid IMT in men with 3 or more risk factors versus 0-2 risk factors was 5.09 (95% CI, 2.05-12.64). CONCLUSIONS: Current findings indicate the need for prevention and control of cardiovascular risk factors in young adults and more focus on those with multiple cardiovascular risk factors.
Adult ; Blood Pressure ; Body Weights and Measures ; Cardiovascular Diseases/*epidemiology ; Carotid Arteries/*physiopathology/ultrasonography ; Female ; Health Behavior ; Hematologic Tests ; Humans ; Korea/epidemiology ; Male ; Risk Factors ; Tunica Intima/*physiopathology

This study investigated the relationship between carotid plaque neovascularization and diabetes mellitus (DM) by using contrast-enhanced ultrasonography. Contrast-enhanced ultrasonography was performed in 104 patients with carotid plaque thicker than 2.0 mm. There were 36 patients with DM and 68 patients without DM. The enhanced intensity in the plaque and the ratio of enhanced intensity in the plaque to that in the lumen of the carotid artery in patients with DM were significantly greater than those in patients without DM. Our study demonstrated that the enhanced intensity in patients with DM is greater than that their counterparts without DM, suggesting that carotid plaque in DM patients may have more neovessels and may be more vulnerable.
Aged ; Carotid Arteries ; diagnostic imaging ; physiopathology ; Contrast Media ; Diabetes Mellitus ; physiopathology ; Female ; Humans ; Image Enhancement ; methods ; Male ; Middle Aged ; Neovascularization, Pathologic ; diagnosis ; diagnostic imaging ; physiopathology ; Plaque, Atherosclerotic ; diagnosis ; diagnostic imaging ; physiopathology ; Reproducibility of Results ; Sensitivity and Specificity ; Ultrasonography ; methods

OBJECTIVETo explore the anti-atherosclerosis effect of Taizhi'an Capsule (TZA) for providing a theoretical base of its application in preventing coronary heart disease (CHD), by way of observing the effects of TZA and pravastatin (PVT) on vascular endothelial function in senile patients with CHD.

METHODSSeventy-eight Senile patients with CHD were randomly divided into the TZA group and the PVT group, 39 in each group. Changes of carotid arterial intima-media thickness (IMT) and brachial arterial endothelium dependent diastolic function (FMD) before and after treatment were observed by non-invasive ultrasound test technique, and levels of serum nitric oxide (NO) and plasma endothelin-1 (ET-1) were determined as well.

RESULTSAfter TAZ treatment, IMT decreased from 1.21 +/- 0.17 mm to 0.91 +/- 0.13 mm, FMD increased from 5.02 +/- 0.58% to 8.97 +/- 0.39%, ET-1 lowered from 95.93 +/- 19.41 ng/L to 49.35 +/- 53.27 ng/L, and NO enhanced from 42.56 +/- 14.12 mumol/L to 69.84 +/- 21.96 mumol/L; after PVT treatment, the corresponding changes were 1.25 +/- 0.21 mm to 0.88 +/- 0.32 mm, 4.90 +/- 0.37% to 8.12 +/- 0.25%, 89.35 +/- 10.02 ng/L to 47.96 +/- 11.05 ng/L and 51.71 +/- 9.39 mumol/L to 72.93 +/- 16.51 mumol/L, all the changes were statistically significant.

CONCLUSIONTZA can obviously improve the vascular endothelial function in old patients with CHD, which has the anti-atherosclerosis effect similar to that of PVT.

Aged ; Angina Pectoris ; diagnostic imaging ; drug therapy ; physiopathology ; Carotid Arteries ; diagnostic imaging ; pathology ; physiopathology ; Coronary Disease ; diagnostic imaging ; drug therapy ; physiopathology ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; physiopathology ; Female ; Humans ; Male ; Phytotherapy ; Pravastatin ; therapeutic use ; Ultrasonography

In this study, we characterized cerebral blood flow changes by assessment of blood flow parameters in neck arteries using carotid duplex ultrasonography and predictive factors for these hemodynamic changes. Hemodynamic variables were measured before and during hemodialysis in 81 patients with an arteriovenous access in their arm. Hemodialysis produced significant lowering in peak systolic velocity and flow volume of neck arteries and calculated total cerebral blood flow (1,221.9 ± 344.9 [before hemodialysis] vs. 1,085.8 ± 319.2 [during hemodialysis], P < 0.001). Effects were greater in vessels on the same side as the arteriovenous access and these changes were influenced by arteriovenous access flow during hemodialysis, both in the CCA (r = -0.277, P = 0.015) and the VA (r = -0.239, P = 0.034). The change of total cerebral blood flow during hemodialysis was independently related with age, presence of diabetes, and systemic blood pressure.
Aged ; Carotid Arteries/diagnostic imaging ; Cerebrovascular Circulation/*physiology ; Dizziness/etiology ; Female ; Hemodynamics/*physiology ; Humans ; Kidney Failure, Chronic/*physiopathology ; Male ; Middle Aged ; Renal Dialysis ; Risk Factors ; Ultrasonography, Doppler, Duplex

In this study, we characterized cerebral blood flow changes by assessment of blood flow parameters in neck arteries using carotid duplex ultrasonography and predictive factors for these hemodynamic changes. Hemodynamic variables were measured before and during hemodialysis in 81 patients with an arteriovenous access in their arm. Hemodialysis produced significant lowering in peak systolic velocity and flow volume of neck arteries and calculated total cerebral blood flow (1,221.9 ± 344.9 [before hemodialysis] vs. 1,085.8 ± 319.2 [during hemodialysis], P < 0.001). Effects were greater in vessels on the same side as the arteriovenous access and these changes were influenced by arteriovenous access flow during hemodialysis, both in the CCA (r = -0.277, P = 0.015) and the VA (r = -0.239, P = 0.034). The change of total cerebral blood flow during hemodialysis was independently related with age, presence of diabetes, and systemic blood pressure.
Aged ; Carotid Arteries/diagnostic imaging ; Cerebrovascular Circulation/*physiology ; Dizziness/etiology ; Female ; Hemodynamics/*physiology ; Humans ; Kidney Failure, Chronic/*physiopathology ; Male ; Middle Aged ; Renal Dialysis ; Risk Factors ; Ultrasonography, Doppler, Duplex

OBJECTIVETo study the effect of Xiaoyu Tablet (XYT) on blood flow parameters and morphology of carotid artery in atherosclerotic patients.

METHODSUsing color Doppler ultrasonographic technique to examine the blood flow parameters and intimal thickness of carotid artery in 20 patients of carotid atherosclerosis after 24 weeks treatment of XYT, and compared with those in 10 patients treated with gastrodine lipid-lowering tablet.

RESULTSAfter 24 weeks treatment, blood flow parameters of carotid artery were obviously improved and intimal thickness of common carotid arteries in both side was markedly decreased. XYT showed an effect better than that of gastrodine lipid-lowering tablet.

CONCLUSIONXYT is effective in increasing blood flow of cervical and cerebral arteries.

Arteriosclerosis ; diagnostic imaging ; drug therapy ; physiopathology ; Blood Flow Velocity ; Carotid Arteries ; diagnostic imaging ; pathology ; Carotid Stenosis ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Tablets ; Tunica Intima ; pathology ; Ultrasonography, Doppler, Color

OBJECTIVETo observe the effect of Wendan Xiezhuo method (WXM) on carotid arteriosclerosis and vascular endothelial diastolic function in essential hypertension (EH) patients with turbid-phlegm syndrome (TPS).

METHODSForty-three EH patients of medium and low risk with TPS were randomly assigned to two groups, the Wendan Tablet (WT) group (23 cases) and the placebo group (20 cases), they were treated with WT and placebo respectively on the base of amlodipine treatment to control the blood pressure. Carotid intimamedia thickness (IMT), atherosclerotic plaque score of carotid artery, endothelium-dependent dilation (EDD) and flow-mediated vasodilation (FMD) of brachial artery after taking nitroglycerin were detected with ultrasonography before and after 6 months of treatment.

RESULTSAs compared with those in the placebo group, in the WT group after treatment, scores of TPS and carotid plaque were better, area of carotid plaque was lesser and IMT was lower significantly (P<0.05 or P<0.01). There was a negative correlation between brachial artery EDD and carotid IMT in EH patients with TPS (r = - 0.596, P < 0.05). After treatment EDD was improved more significantly in the WT group than that in the placebo group, however, no significant difference was found in non-endothelium-dependent dilation between the two groups.

CONCLUSIONA negative correlation exists between brachial artery EDD and carotid IMT, and the latter could be aggravated by TPS in EH patients. WXM shows favorable effects in improving carotid plaque and EDD.

Aged ; Atherosclerosis ; complications ; pathology ; physiopathology ; Carotid Arteries ; diagnostic imaging ; drug effects ; physiopathology ; Carotid Artery Diseases ; complications ; diagnostic imaging ; pathology ; Drugs, Chinese Herbal ; therapeutic use ; Endothelium, Vascular ; drug effects ; pathology ; physiopathology ; Female ; Humans ; Hypertension ; complications ; drug therapy ; pathology ; Male ; Middle Aged ; Phytotherapy ; Syndrome ; Treatment Outcome ; Ultrasonography

OBJECTIVETo investigate the predictive value of the ambulatory blood pressure monitoring parameters on left ventricular hypertrophy (LVH) and carotid artery intima-media thickness (IMT) in the hypertensives.

METHODSWe evaluated 147 hypertensive patients who were never treated regularly before. All patients underwent ultrasound examinations of the heart and the IMT of carotid arteries. We classified them as LVH group (n = 45) or no LVH group (n = 102), and as IMT increased group (n = 52) or no IMT increased group (n = 95). The record of medical history, physical examination and 24 h ambulatory blood pressure monitoring (ABPM) were performed in all the patients. The biochemical parameters such as blood lipids, glucose and so on were tested. Then the data comparison was made.

RESULTS(1) There were no significant differences in clinical manifestations and biochemical parameters between the LVH and no LVH groups (P > 0.05). Age (68.3 +/- 6.2) year vs (65.6 +/- 5.8) year, male 75.6% vs 66.7%, body mass index (24.1 +/- 4.1) vs (23.8 +/- 4.7) (kg/m(2)), diabetes mellitus and(or) impaired glucose tolerance 40.0% vs 38.2%, angina pectoris 42.3% vs 38.9%, cerebral vascular diseases 19.2% vs 15.7%, total cholesterol (5.40 +/- 1.42) vs (5.28 +/- 1.46) mmol/L, triglycerides (1.80 +/- 1.02) vs (1.74 +/- 1.08) mmol/L, low-density lipoprotein cholesterol (4.03 +/- 1.43) vs (4.06 +/- 1.48) mmol/L, high-density lipoprotein cholesterol (1.00 +/- 0.30) vs (0.99 +/- 0.26) mmol/L. (2) The parameters of ABPM in LVH group were higher than those in no LVH group. There were significant differences (P < 0.05) in 24 h mean systolic blood pressure (140.7 +/- 14.1) vs (128.3 +/- 12.3) mm Hg, 24 h mean diastolic blood pressure (86.4 +/- 8.9) vs (81.6 +/- 9.3) mm Hg, daytime mean systolic blood pressure (142.8 +/- 13.9) vs (130.9 +/- 11.1) mm Hg, daytime mean diastolic blood pressure (86.9 +/- 8.8) vs (83.4 +/- 9.0) mm Hg, nighttime mean systolic blood pressure (129.0 +/- 13.2) vs (114.6 +/- 11.4) mm Hg, nighttime mean diastolic blood pressure (77.2 +/- 9.4) vs (67.5 +/- 8.1) mm Hg, 24 h pulse pressure (54.2 +/- 10.2) vs (46.9 +/- 9.6) mm Hg, daytime pulse pressure (55.9 +/- 10.5) vs (47.5 +/- 9.1) mm Hg, nighttime pulse pressure (51.8 +/- 10.7) vs (47.1 +/- 8.7) mm Hg, 24 h systolic blood pressure variance (8.4 +/- 2.0) vs (7.2 +/- 1.9), 24 h diastolic blood pressure variance (9.5 +/- 2.2) vs (8.0 +/- 2.1), the non-dipper rhythm of ambulatory blood pressure 55.6% vs 25.5%. (3) There were also no significant differences in clinical manifestations between the IMT increased and no IMT increased group (P > 0.05). While there were significant differences between the IMT increased and no IMT increased group in those parameters of ABPM (P < 0.05).

CONCLUSIONThere were more LVH or IMT increased persons in the hypertensives whose ABPM parameters were abnormal.

Aged ; Aged, 80 and over ; Blood Pressure ; Blood Pressure Monitoring, Ambulatory ; Carotid Arteries ; diagnostic imaging ; pathology ; Female ; Humans ; Hypertension ; diagnostic imaging ; pathology ; physiopathology ; Hypertrophy, Left Ventricular ; diagnostic imaging ; pathology ; Male ; Middle Aged ; Predictive Value of Tests ; Ultrasonography