Carotid intima-media thickness as a marker of cardiovascular risk in hypertensive patients with coronary artery disease

Am J Hypertens. 2007 Oct;20(10):1058-64. doi: 10.1016/j.amjhyper.2007.05.011.


Background: The aim of this study was to examine the significance of ultrasound-measured carotid intima-media thickness (CIMT) in high-risk patients with hypertension and coronary artery disease (CAD), as an independent prognostic factor in determining the risk of all-cause death or future cardiovascular events.

Methods: The study included 297 consecutive patients (mean age +/- SD, 57 +/- 9.4 years) with diagnosed hypertension and CAD, referred for coronary angiography. The mean of maximal CIMT in two arterial segments bilaterally was calculated. The primary endpoint was a patient's death from all causes. Death, stroke, or myocardial infarction comprised the secondary, composite endpoint.

Results: There was a follow-up of 1 to 79 (mean, 41) months. The predictors of death in a multivariate Cox proportional hazards model were the number of stenosed coronary arteries (P = .007) and CIMT (P = .001). The risk of the secondary, composite endpoint (death, stroke, or myocardial infarction) was determined by diabetes (P = .008) and CIMT (P = .010). Nearly 99% of patients with "low CIMT" (< or =1.13 mm) survived for 5 years, versus 78% with "high CIMT" >1.13 mm (log-rank test; P < .001). For the secondary, composite endpoint (death, stroke, or myocardial infarction), the event-free survival rate was 95% (low CIMT), versus 74% after 5 years (high CIMT) (P < .008).

Conclusions: Intima-media thickness of the carotid arteries is a strong and independent predictor of death and serious cardiovascular events in hypertensive patients with CAD referred for coronary angiography.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers
  • Carotid Arteries / diagnostic imaging
  • Carotid Arteries / pathology*
  • Coronary Artery Disease / complications
  • Coronary Artery Disease / diagnosis*
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / mortality
  • Female
  • Follow-Up Studies
  • Humans
  • Hypertension / complications
  • Hypertension / diagnosis*
  • Hypertension / diagnostic imaging
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Myocardial Infarction / mortality
  • Predictive Value of Tests
  • Prognosis
  • Risk Factors
  • Stroke / mortality
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / pathology*
  • Tunica Media / diagnostic imaging
  • Tunica Media / pathology*
  • Ultrasonography, Doppler, Duplex


  • Biomarkers