Document Detail

Pulse pressure is independently associated with carotid plaque ulceration.
MedLine Citation:
PMID:  12923399     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Plaque rupture is the principal cause of acute coronary ischaemia, and unstable carotid plaques are associated with a high risk of ischaemic stroke. Carotid plaque ulceration also predicts acute coronary events, suggesting that systemic factors may determine plaque instability. One potentially important factor is pulse pressure. There is indirect evidence that cyclical haemodynamic forces affect plaque stability, and pulse pressure is a strong predictor of coronary events. OBJECTIVE: To study the association between pulse pressure and plaque ulceration. DESIGN AND METHODS: We studied angiograms from 3007 patients with recently symptomatic carotid stenosis in the European Carotid Surgery Trial. Presence of ulceration was related to the different components of blood pressure [pulse pressure, systolic blood pressure (SBP), mean arterial pressure (MAP), and diastolic blood pressure (DBP)], and adjustment was made for age, sex, diabetes, smoking, and the degree of vessel stenosis. RESULTS: Pulse pressure was the strongest independent predictor of ulceration of the symptomatic carotid plaque [adjusted odds ratio (OR) for the upper compared with the lower quintile 2.07, 95% confidence interval (CI) 1.25 to 3.44; P = 0.004]. This relationship was weaker for SBP (OR 1.66, 95% CI 1.05 to 2.62; P = 0.02), and non-significant for MAP (OR 1.58, 95% CI 1.01 to 2.48, P = 0.13) and DBP (OR 1.67, 95% CI 0.73 to 1.87, P = 0.50). CONCLUSIONS: Pulse pressure is independently associated with carotid plaque ulceration, supporting the hypothesis that pulsatile haemodynamic forces are an important cause of plaque rupture.
Joanna K Lovett; Sally C Howard; Peter M Rothwell
Related Documents :
21641509 - Pressure ulcers in long-term care.
8226509 - Contribution of in vivo microvascular po2 in the cat carotid body chemotransduction.
16740639 - The influence of heart rate on baroreceptor fibre activity in the carotid sinus and aor...
24615469 - Attenuated right ventricular energetics evaluated using (11)c-acetate pet in patients w...
19870869 - Studies on experimental hypertension : ix. the effect on blood pressure of constriction...
17288989 - Pain and the rate of dentinal fluid flow produced by hydrostatic pressure stimulation o...
Publication Detail:
Journal Detail:
Date Detail:
Created Date:  2003-08-18     Completed Date:  2003-11-04     Revised Date:  2006-11-15    
Medline Journal Info:
Other Details:
Languages:  eng     Pagination:  1669-76     Citation Subset:  IM    
Department of Clinical Neurology, Radcliffe Infirmary, Oxford, UK.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Blood Pressure*
Carotid Stenosis / mortality*,  pathology*,  surgery
Cerebral Angiography
Follow-Up Studies
Middle Aged
Predictive Value of Tests
Risk Factors


Previous Document:  Selective cyclo-oxygenase-2 inhibition with parecoxib acutely impairs endothelium-dependent vasodila...
Next Document:  The sympathetic nervous system in hypertension: assessment by blood pressure variability and ganglio...