Ho Joong Youn

The changes of individual carotid artery wall layer by aging and carotid intima-media thickness value for high risk.

AIMnIt is still unclear which layer (intima or media) is mainly involved in increased carotid intima-media thickness (CIMT) by aging and also unclear regarding CIMT value suggesting high cardiovascular risk, although 75th percentile value of CIMT is known as a high risk in asymptomatic adults. We sought to find the changes of carotid intima thickness (CIT) and carotid media thickness (CMT) by aging and the 75th percentile value of CIMT in asymptomatic Korean adults.nnnMETHODnThis is an observational cohort study. Carotid ultrasound findings (n=2204 from 12 hospitals) were prospectively collected. The carotid images were sent to Korea Research Institute of Standards and Science for analysis using specialized software which can measure intima and media wall also.nnnRESULTSnMean age was 58.1±13.5xa0years old (52% of men). Pearsons correlation coefficient between age and right CIMT (r=.489, P<.001) and right CMT (r=.482, P<.001) was higher than that between age and right CIT (r=.284, P<.001). Mean right CIMT in male and female was 0.696±0.163 and 0.686±0.167xa0mm (P=.180), and the 75 percentile value was 0.778 and 0.771xa0mm, respectively. Mean right CIT was 0.311±0.069 and 0.303±0.064xa0mm (P=.009), and mean right CMT was 0.391±0.124 and 0.388±0.131xa0mm (P=.694) in male and female, respectively. Left carotid ultrasound findings showed similar to the right one.nnnCONCLUSIONnAn increased CIMT by aging was mainly due to increased CMT rather than CIT in asymptomatic adults. The 75th percentile values of right CIMT were 0.778 and 0.771xa0mm in asymptomatic Korean male and female adults, respectively.

Can pulse pressure predict the white-coat effect in treated hypertensive patients?

Although the white-coat effect (WCE) is not rare, its detection is often difficult in treated hypertensive patients. The aim of this study was to elucidate the factors that affect and predict the WCE in treated hypertensive patients in Korea. A total of 1087 outpatients (mean age: 57 ± 10 y; 52% female) checked blood pressure in office and at home. We divided the outpatients into two groups according to the presence or absence of the WCE. Waist circumference was smaller in the WCE group. In addition, in the WCE group, the incidence of diabetes mellitus (DM) was lower, but family history of premature cardiovascular disease was higher. Target organ damage, including damage to the heart, was lower in the WCE group. Pulse pressure (PP) in the clinic was higher in the WCE group and was also positively correlated with a systolic WCE, especially when measured by a doctor (r = 0.511, P < .001). By multivariate regression analysis, PP measured by a doctor independently correlated with systolic WCE (ß = 0.573, P < .001). Our findings suggest that PP measured by a doctor at a clinic may predict the WCE, which can help in the treatment of hypertensive patients.