Abstract: Objective To study the impact of prehypertension on carotid artery intima-media thickness (IMT) in the middle-aged and elderly population.Methods We studied 942 residents in a community of Guangzhou, China by questionnaires, physical examinations, blood chemistry tests and bilateral carotid ultrasonography. Carotid artery IMT of common carotid artery, carotid bifurcation and internal carotid artery as well as mean carotid artery IMT were compared among the three populations of normotension (NT), prehypertension (Pre-HT) and hypertension (HT), which were stratified by the JNC-7 classification of blood pressure.Results Pre-HT and HT were associated with the risk factors such as older age, male gender, dyslipidemia, obesity and smoking. IMT of the three carotid segments and mean IMT was thicker in Pre-HT than in NT (P<0.001). Adjusting for relevant risk factors, IMT of common carotid artery and mean carotid IMT was still significantly thicker in the Pre-HT than in NT (P<0.05). However, significant difference between the IMT of carotid bifurcation and internal carotid artery in Pre-HT and NT could not be found (P=0.082 and P=0.133). IMT of the common carotid and carotid bifurcation as well as mean IMT was thicker in HT than in Pre-HT or in NT (all P<0.05).Conclusion There was significant target-organ damage such as thickening of the carotid artery IMT in the prehypertension status in middle-aged and elderly population.

Key words: Hypertension; Intima-media thickness; Carotid artheries; Community; Middle aged; Aged

摘要： 目的 探讨高血压前期对社区中老年人群颈动脉内中膜厚度（intima-media thickness，IMT）的影响。方法 对942名46～75岁广州社区居民进行问卷调查、体格检查、血生化检查和双侧颈动脉超声检查，根据JNC-7的血压分类标准，比较正常血压（normotension，NT）、高血压前期（prehypertension，Pre&#8209;-HT）和高血压（hypertension，HT）3亚组人群颈总动脉、分叉部、颈内动脉以及平均IMT大小。结果 Pre&#8209;-HT和HT均与高龄、男性、肥胖、血脂异常、吸烟等危险因素相关。Pre&#8209;-HT人群颈动脉各段及平均IMT均比NT人群明显增厚（P<0.001）。控制相关危险因素后，Pre&#8209;-HT人群平均IMT和颈总动脉IMT比NT人群明显增厚（P<0.05），而颈动脉分叉部IMT和颈内动脉IMT增厚未达到统计学意义（P=0.082，0.133）。HT人群颈总动脉、分叉部IMT及平均IMT均比NT、Pre&#8209;-HT人群明显增厚（P均<0.05）。结论 处于高血压前期的中老年人群已存在较明显的靶器官损害——颈动脉内中膜增厚。

关键词: 高血压; 内中膜厚度; 颈动脉; 社区; 中年人; 老年人