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(Hypertension. 1997;29:361.)
© 1997 American Heart Association, Inc.

Arthur C. Corcoran Memorial Lecture

Intima-Media Thickness of the Carotid Artery in Hypertensive Subjects and Hypertrophic Cardiomyopathy Patients

Yusuke Ohya; Isao Abe; Koji Fujii; Kazuo Kobayashi; Uran Onaka; Masatoshi Fujishima

From the Second Department of Internal Medicine, Kyushu University, Faculty of Medicine, Fukuoka, Japan.

Correspondence to Yusuke Ohya, MD, PhD, Second Department of Internal Medicine, Kyushu University, Faculty of Medicine, 3-1-1 Maidashi, Higashi-ku, Fukuoka 812-82, Japan. E-mail ohya{at}intmed2.med.kyushu-u.ac.jp

While hypertension is known to cause left ventricular and vascular hypertrophy, the relationship between alterations of vascular and cardiac structures in patients with hypertrophic cardiomyopathy has not been fully clarified. We measured intima-media thickness of carotid arteries by ultrasonography in patients with hypertrophic cardiomyopathy (n=16), normotensive subjects (n=358), and hypertensive subjects (n=386) in a cohort of 7940 male employees of a bus company. Our object was to determine whether vascular alteration occurs in hypertrophic cardiomyopathy similarly as in hypertension. Hypertrophic cardiomyopathy (wall thickness 15 mm; asymmetrical hypertrophy without hypertension) was screened with family history and electrocardiography followed by echocardiography. The intima-media thickness in patients with hypertrophic cardiomyopathy (mean, 0.61 mm) did not differ from that of normotensive subjects (0.60 mm) but was significantly less than that of hypertensive subjects with left ventricular hypertrophy (wall thickness BORDER="0"> 14 mm; n=22; 0.73 mm). In a scatterplot of intima-media thickness versus interventricular septal thickness, these two parameters were significantly correlated in normotensives and hypertensives. The patients with hypertrophic cardiomyopathy distributed outside the 95% confidence range of the normotensive and hypertensive subjects. In summary, the increase in intima-media thickness of the carotid artery paralleled left ventricular hypertrophy in normotensive and hypertensive subjects. Patients with hypertrophic cardiomyopathy had a normal intima-media thickness regardless of the hypertrophied left ventricle. Thus, information on intima-media thickness may be useful in differentiating hypertensive left ventricular hypertrophy from hypertrophic cardiomyopathy.

Key Words: risk factor • left ventricular hypertrophy • echocardiography • ultrasound • atherosclerosis • target organ damage

Abbreviations: BP = blood pressure • ECG = electrocardiogram • HCM = hypertrophic cardiomyopathy • HT1 = hypertensive subjects with interventricular septal thickness <13 mm • HT2 = hypertensive subjects with interventricular septal thickness 13 mm but <14 mm • HT3 = hypertensive subjects with interventricular septal thickness 14 mm • IMT = intima-media thickness • LV = left ventricle, left ventricular

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