Carotid Intima–Media Thickness and Improved Stroke Risk Assessment in Hypertensive Black Adults

• Published in: American journal of hypertension 2024-03, Vol.37 (4), p.290-297
• Main Authors: Abe, Temidayo A, Olanipekun, Titilope, Yan, Fengxia, Effoe, Valery, Udongwo, Ndausung, Oshunbade, Adebamike, Thomas, Victoria, Onuorah, Ifeoma, Terry, James G, Yimer, Wondwosen K, Ghali, Jalal K, Correa, Adolfo, Onwuanyi, Anekwe, Michos, Erin D, Benjamin, Emelia J, Echols, Melvin
• Format: Article
• Language: English
• ISSN: 0895-7061; 1941-7225; 1941-7225
• DOI: 10.1093/ajh/hpae008

Abstract BACKGROUND We aim to determine the added value of carotid intima–media thickness (cIMT) in stroke risk assessment for hypertensive Black adults. METHODS We examined 1,647 participants with hypertension without a history of cardiovascular (CV) disease, from the Jackson Heart Study. Cox regression analysis estimated hazard ratios (HRs) for incident stroke per standard deviation increase in cIMT and quartiles while adjusting for baseline variables. We then evaluated the predictive capacity of cIMT when added to the pool cohort equations (PCEs). RESULTS The mean age at baseline was 57 ± 10 years. Each standard deviation increase in cIMT (0.17 mm) was associated with approximately 30% higher risk of stroke (HR 1.27, 95% confidence interval: 1.08–1.49). Notably, cIMT proved valuable in identifying residual stroke risk among participants with well-controlled blood pressure, showing up to a 56% increase in the odds of stroke for each 0.17 mm increase in cIMT among those with systolic blood pressure