Impact of H-Type Hypertension on Intraplaque Neovascularization Assessed by Contrast-Enhanced Ultrasound

• Published in: Journal of Atherosclerosis and Thrombosis 2022/04/01, Vol.29(4), pp.492-501
• Main Authors: Tan, Yuting, Nie, Fang, Wu, Guode, Guo, Fangzhou, Wang, Yanqing, Wang, Longli
• Format: Article
• Language: English
• Subjects: Carotid Arteries - diagnostic imaging; Carotid atherosclerotic plaque; Carotid Stenosis - complications; Carotid Stenosis - diagnostic imaging; Contrast Media; Contrast-enhanced ultrasound; H-type hypertension; Humans; Hypertension - complications; Hypertension - diagnostic imaging; Ischemic stroke; Neovascularization; Neovascularization, Pathologic; Original; Plaque, Atherosclerotic - diagnostic imaging; Ultrasonography
• ISSN: 1340-3478; 1880-3873; 1880-3873
• DOI: 10.5551/jat.61275

Aim: H-type hypertension is connected with carotid atherosclerotic plaques and stroke, whereas neovascularization is a dominant contributor to plaque vulnerability. However, the correlation between H-type hypertension and plaque vulnerability remains unclear. This study aims to explore the influence of H-type hypertension on intraplaque neovascularization (IPN). Methods: We enrolled 235 patients with carotid plaques into the investigation and classified them into four groups: H-type hypertension group, simple hypertension group, isolated hyperhomocysteinemia group, and control group. Contrast-enhanced ultrasound (CEUS) was performed on them and IPN was evaluated using semi-quantitative visual grading: grade 1 (no microbubbles or microbubbles limited to the adventitial side and/or shoulder of plaque) and, grade 2 (diffused microbubbles within plaque or microbubbles enter plaque core). To analyze the correlation between H-type hypertension and the degree of plaque enhancement, logistic regression was used. Results: Compared with those with CEUS grade 1 plaques, those with CEUS grade 2 plaques had higher frequency of ischemic stroke (29.0% vs. 45.1%, P＜0.05), hypertension (41.0% vs. 56.3%, P＜0.05), and H-type hypertension (18.0% vs. 29.6%, P＜0.05). No significant differences existed in plaque morphology, plaque echogenicity, and the severity of carotid artery stenosis between the degree of plaque enhancement (all P＞0.05). H-type hypertension (multivariate-adjusted OR: 3.036, 95% CI: 1.258–7.329) was independently connected with the degree of plaque enhancement even after adjusting for other covariates. Conclusion: H-type hypertension is expressly connected with the degree of plaque enhancement and may facilitate plaque vulnerability. Our findings may offer a new insight for treating vulnerable plaque, lowering blood pressure, and lowering homocysteine equally crucial.