Rapid ultrasound score as an indicator of atherosclerosis' clinical manifestations in a population of hypertensives: the interrelationship between flow-mediated dilatation of brachial artery, carotid intima thickness, renal resistive index and retina resistive index of central artery.

Objective: Flow-mediated dilatation (FMD) of brachial artery, renal resistive index (RRI), retina resistive index of central artery (RRICA) and carotid intima-media thickness (IMT) have been used for ultrasound assessment of cardiovascular risk as good surrogate markers of pre-clinical atherosclerosis. We investigated the interrelationship of these four parameters and examined whether an integrated score is a good indicator of atherosclerotic disease in hypertensives.

Methods: One-hundred fifty-two consecutive subjects were enrolled in this study between April 2004 and April 2005. Each patient underwent cerebral computed tomography, coronarography, carotid, renal, central retinal and femoral arteries Doppler ultrasonographic evaluation. Statistical analysis was performed using ANOVA, Fisher test, Pearson correlation and stepwise regression analyses.

Results: FMD, RRICA, IMT and RRI were significantly correlated with each other. In multiple regression analysis age, pulse pressure, hypertension duration were independently related with the four parameters. Eighty-one findings of total atherosclerotic disease (ADAD were recorded overall (15 cerebrovascular disease, 20 coronary heart disease or myocardial infarction, 22 carotid plaques and 24 low limb plaques). Using an integrated score we were able to divide the population into three scoring bands. In the lowest band we classified 87 patients with 16% of total AD; in the intermediate 40 patients with 30% of total AD, in the highest 25 patients with 54% of total AD. Differences between groups were significant (p<0.05).

Conclusion: A potential benefit of these integrated, low-cost and easy-to-detect parameters, is the stratification of patients with atherosclerotic risk. This method may prove useful in discovering those with atherosclerosis in a pre-clinical stage for whom therapy initiated before complications could reduce the risk for a cerebro-cardio-vascular event.