This Article Full Text Full Text (PDF) CME: Take the course for this article: Hypertension: October 2008, Volume 52, Number 4 All Versions of this Article: 52/4/729    most recent HYPERTENSIONAHA.108.115972v1 Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Beaussier, H. Articles by Laurent, S. Search for Related Content PubMed PubMed Citation Articles by Beaussier, H. Articles by Laurent, S. Related Collections Remodeling Cerebrovascular disease/stroke Clinical Studies Carotid Stenosis Doppler ultrasound, Transcranial Doppler etc.

(Hypertension. 2008;52:729.)
© 2008 American Heart Association, Inc.

Original Articles

Carotid Plaque, Arterial Stiffness Gradient, and Remodeling in Hypertension

Hélène Beaussier; Ingrid Masson; Cédric Collin; Erwan Bozec; Brigitte Laloux; David Calvet; Mustapha Zidi; Pierre Boutouyrie; Stéphane Laurent

From the Department of Pharmacology and INSERM UMRS 872 (H.B., I.M., C.C., E.B., B.L., P.B., S.L.), Hôpital Européen Georges Pompidou, Université Paris Descartes, France; Institut Supérieur des Biosciences de Paris and CNRS UMR 7054 (I.M., M.Z.), Université Paris, Créteil cedex, France; and Department of Neurology (D.C.), Hôpital Sainte-Anne, Université Paris Descartes, France.

Reprint requests to Pr Stéphane Laurent, Department of Pharmacology and INSERM U872, Hôpital Européen Georges Pompidou, Assistance Publique - Hôpitaux de Paris, Université Paris 5, 20, rue Leblanc, 75015 Paris, France. E-mail stephane.laurent{at}egp.ap-hop-paris.fr

The analysis of plaque mechanics along the longitudinal axis (bending strain) may provide useful information because repetitive bending strain of an atherosclerotic plaque can fatigue the wall material and result in plaque rupture. Whether essential hypertension is associated with a specific pattern of bending strain has not yet been determined. The study included 92 patients with an atherosclerotic plaque on the common carotid artery: 66 patients with essential hypertension, either treated or not, and 26 normotensive patients. A novel noninvasive echotracking system (ArtLab; Esaote, The Netherlands) was used to measure intima-media thickness, diameter, and distensibility at 128 sites on a 4-cm-long carotid segment. Carotid plaque was either less elastic than adjacent carotid artery (inward strain) or more elastic (outward strain). Inward strain was more frequently associated with an inward plaque remodeling, whereas an outward strain was more frequently associated with an outer remodeling. In multivariate logistic regression analysis, patients with essential hypertension were more likely to exhibit an inward strain of carotid plaque (odds ratio=6.9 [1.4 to 34.9]; P<0.02), independently of 2 factors favoring inward strain: an outer remodeling (odds ratio=4.6 [1.7 to 13.4]; P<0.005) and the absence of renin-angiotensin system blockers (odds ratio=4.8 [1.1 to 20.4]; P<0.05). In conclusion, arterial wall material of hypertensive patients was less elastic at the site of the plaque than upstream, and carotid was inwardly strained in the zone affected by plaque. This may generate a high level of stress concentrations and fatigue, exposing the plaque to a greater risk of rupture.

Key Words: carotid artery • atherosclerotic plaque • hypertension • stiffness • arterial remodeling