Carotid vascular strain predicts cardiovascular events in patients with hypertension

Background: We aim to investigate prognostic effects of carotid strain (CS) and strain rate (CSR) in hypertension. Methods: We prospectively recruited 120 patients being treated for hypertension (65.8 +/- 11.8 years, 58% male) in this observational study. Peak circumferential CS and peak CSR after ejection were identified using two-dimensional speckle tracking ultrasound. Major cardiovascular events were any admission for stroke, acute coronary syndrome, and heart failure. Results: After a mean follow-up period of 63.6 +/- 14.5 months, 14 (12%) patients had cardiovascular events. Age (75.3 +/- 9.2 vs 64.6 +/- 11.6 years; p = 0.001), systolic blood pressure (131.8 +/- 15.5 vs 143.1 +/- 16.6 mm Hg; p = 0.021), diastolic blood pressure (74.6 +/- 11.4 vs 82.1 +/- 12.2 mm Hg; p = 0.039), use of diuretics (71 vs 92%; p = 0.014), carotid CS (2.17 +/- 1.02 vs 3.28 +/- 1.14 %; p = 0.001), and CSR (.28 +/- .17 vs .51 +/- .18 1/s; p < 0.001) were significantly different between the patients who did and did not reach the end-points. Multivariate Cox regression analysis controlling for age, systolic blood pressure, diastolic blood pressure, and use of diuretics showed that CS (HR .425, 95%CI .223-.811, p = 0.009) and CSR (HR .001, 95%CI .000-.072, p = 0.001) were independent predictors for cardiovascular events. Conclusion: In conclusions, decreased CS and CSR were associated with cardiovascular events in hypertension.