Carotid Artery Atherosclerotic Disease Assessed by Flow Velocity Wave Form Analysis in Hemodialyzed Normotensive and Hypertensive Patients

Abstract

Cerebrovascular accidents, often secondary to severe atherosclerotic disease, are very common in uremic patients on long-term hemodialysis. The aim of the present study is to assess asymptomatic carotid artery atherosclerotic disease (CAAD) in hemodialyzed normotensive and hypertensive patients in comparison with age-matched controls, by the use of Doppler ultrasound flow velocity wave form analysis (FVWFA), recorded from the common carotid artery. This study was performed on 47 subjects divided into four groups: 10 young and 10 middle-aged normals were considered in groups I and II, respectively, 5 young uremic normotensive, 6 young uremic hypertensive and 16 middle-aged uremic normotensive patients in groups III, IV and V, respectively. All the examined patients were nonsmokers, without diabetes or cardiopathy. The five wave form dimensions most capable of separating different degrees of atherosclerotic disease were determined on every common carotid tracing and used in a single best fit discriminant equation; the resultant discriminant score (DS) classified each carotid tracing and consequently every group’s range. DS of groups I and III were not different, but significantly higher compared to the other three groups; besides DS was statistically not different in groups II, IV and V. In conclusion, FVWFA did not detect a different degree of CAAD between normotensive dialyzed patients and age-matched normals, whereas the blood pressure pharmacological control did not affect the velocity findings of advanced CAAD in young uremic hypertensive patients.