Comparative Study of Carotid Artery Disease in Hypertensive Versus Non-Hypertensive Patients Using Color Doppler Flow Imaging

Background: Carotid artery disease is prevalent in individuals with hypertension and renal failure, often characterized by the thickening of the fibromuscular layers of the intima and media, and narrowing of the lumens in smaller arteries and arterioles. This condition increases the risk of atherosclerotic vascular diseases affecting the coronary and cerebral vessels, which can lead to myocardial infarction and stroke. Hypertension is a major contributing factor to these structural changes, increasing the susceptibility to carotid artery disease. Objective: This study aimed to compare the Color Doppler results for evaluating carotid artery disease in patients with and without hypertension, focusing on differences in intima-media thickness (IMT) and other Doppler indices between these two groups. Methods: A cross-sectional study was conducted on 120 patients at the ultrasound clinic of the University of Lahore. The study included 72 hypertensive and 48 non-hypertensive individuals with clinical indications of carotid artery disease. The sample size was calculated based on the prevalence of hypertension in Pakistan. Doppler ultrasonography was performed using a Toshiba XARIO XG machine equipped with a linear probe operating at 5-7.5 MHz. Patients were selected based on clinical indications, and both male and female participants were included, while those who were unwilling or uncooperative were excluded. Data analysis was conducted using SPSS version 25.0, and parameters such as age, presence of hypertension and diabetes, gender, and intima-media thickness were recorded. The study analyzed the mean ± standard deviation of Resistive Index, Pulsatility Index, End Diastolic Velocity, and Peak Systolic Velocity. An independent t-test was used to compare Doppler indices between hypertensive and non-hypertensive participants, with a significance level set at p < 0.05. Results: The study revealed significant differences in intima-media thickness (IMT) between hypertensive and non-hypertensive groups. In non-hypertensive patients, the mean ± standard deviation of IMT was 0.56 ± 0.14 mm for the right carotid artery and 0.57 ± 0.14 mm for the left. In hypertensive patients, these values were 0.63 ± 0.16 mm for the right and 0.62 ± 0.14 mm for the left carotid artery. The differences were statistically significant with p-values of 0.013 and 0.048 for the right and left carotid arteries, respectively. No significant differences were observed in other Doppler indices, such as RI, PI, PSV, and EDV, between the two groups. Conclusion: Hypertension is a major risk factor significantly associated with increased carotid intima-media thickness and plaque formation. Monitoring blood pressure and using Doppler ultrasound for early detection of increased IMT can help prevent carotid artery plaque formation and improve the prognosis of cardiovascular and cerebrovascular diseases. Pakistan.