Determination of subclinical atherosclerosis by total plaque area in patients with diabetes and hypertension

Abstract Background/objective the determination of the carotid total plaque area (TPA) is an indicator of subclinical atherosclerosis and a useful tool in early cardiovascular prevention. Classically, diabetes has been considered the most atherogenic disease, even more so than hypertension, but the incidence of stroke and heart attack is higher in patients with hypertension than in patients with diabetes alone. Therefore, in this study, we compared hypertension and diabetes with regard to the burden of atherosclerosis. Methods a cross-sectional observational study was carried out on adults (n = 606). Those with a history of a cardiovascular event were excluded. Results median age was 65 years (IQR 17), 58.6% women. People with diabetes and hypertension had the highest TPA (β exponent: 1.64; 95% CI 1.20–2.26), followed by people with hypertension alone (β exponent: 1.39; 95% CI 1.05–1.86), while people with diabetes alone had no differences (P = .379) with respect to the control group. Conclusion This cross-sectional study, though limited, emphasizes the need for larger prospective studies to validate the clinical significance of these findings and highlights the importance of routine monitoring of subclinical atherosclerosis in hypertensive patients to assess the effectiveness of preventive therapy.