Objective: To explore the association of hypertension and carotid atherosclerosis in a general population in China.
Methods: A population-based cardiovascular epidemiology survey was performed in a total of 1198 residents in suburban Beijing, 426 men and 776 women aged 43-73 years. Carotid plaque and the intima-media thickness were measured using duplex ultrasound.
Results: The intima-media thickness, the prevalence of plaque and the number of plaques were found significantly positively related to hypertension categories (optimal, normal, high-normal, stage 1, 2 and 3 hypertension, according to The Chinese Hypertension Guidelines) as well as to the duration of hypertension, with a dose-response pattern in both genders (trend test, P < 0.01). After adjustment for age, total cholesterol, high-density lipoprotein-cholesterol, fasting glucose, smoking, antihypertensive treatment, stroke, myocardial infarction and angina, the relationship still existed, particularly in women. The associations of carotid atherosclerosis with duration of hypertension were weakened by further adjustment for systolic blood pressure, diastolic blood pressure or hypertension categories.
Conclusion: Hypertension was associated with subclinical carotid atherosclerosis. A prolonged course of the disease may aggravate the carotid atherosclerosis, independently of the level of blood pressure.