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Effect of Hypertension on Carotid Plaque Formation and Outcomes in High-Risk Cerebrovascular Population: A Community-Based Study in Guangzhou

Shunyu Zhang1, Xingdong Deng1,2, Huaixiang Liu1, Mingshu Mo 1, Pingyi Xu 1,2,* and Zuojun Tian 1,*
1 Department of Neurology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 511436, China 2 Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830017, China * Correspondence: Pingyi Xu, Department of Neurology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 511436, China, Xinjiang Medical University, Urumqi, Xinjiang Uygur Autonomous Region, 830017, China; Zuojun Tian, Department of Neurology, the First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 511436, China

Vol. 4 (2025): 2025 International Conference on Agricultural Sciences, Economics, Biomedical and Environmental Sciences (SEMBE 2025)

Received: 2026-05-23

Accepted: 2026-05-23

Published: 2026-05-23

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Abstract

Objective: This study investigates the effects of hypertension on carotid plaque formation and clinical outcomes in a high-risk population for cerebrovascular disease in the Guangzhou communities. Methods: Data from 322 high-risk individuals for cerebrovascular disease in the Guangzhou communities were consecutively collected between January 2018 to December 2023. These participants were hospitalized twice within one year at the Department of Neurology, the First Affiliated Hospital of Guangzhou Medical University, and underwent carotid ultrasound examinations during both admissions. Based on the carotid ultrasound results from the first hospitalization, participants were initially categorized into two groups (with or without plaque) to analyze the association between hypertension and carotid plaque formation using univariate and multivariate methods. Subsequently, the cohort was further divided into three groups according to hypertension control status across both admissions: a non-hypertensive group (n = 48), a hypertension controlled group (average blood pressure (BP) < 130/80 mmHg at both admission, n = 109), and a hypertension uncontrolled group (average BP ≥ 130/80 mmHg at either admission, n = 165). Differences in the variance of Crouse scores (ΔCrouse) between the two ultrasound examinations were analyzed among the three groups. Further stratification analysis was performed by dividing participants into two age subgroups (cutoff: 70 years) and three hypertension control subgroups (average BP < 130/80 mmHg at two-time admissions, one-time admission, or neither). The differences in ΔCrouse were then analyzed across these stratified subgroups. Results: Age (OR = 1.074, P = 0.000), gender (OR = 0.340, P = 0.000), SBP (OR = 1.039, P = 0.006), and DBP (OR = 0.932, P = 0.003) were significantly associated with carotid plaque formation. No statistically difference in ΔCrouse was observed between the hypertension controlled group and the non-hypertensive group; however, ΔCrouses in the above two groups showed significant differences from that in hypertension uncontrolled group (both, P < 0.01). Furthermore, similar trends were found in both age subgroups (≥ 70 years and < 70 years). The two-time controlled hypertension subgroup exhibited significantly smaller ΔCrouse value than the one-time and two-time uncontrolled subgroups (both, P < 0.05), while no significant difference was found between the one-time and two-time uncontrolled subgroups. Conclusions: Age, gender, SBP, and DBP were identified as influential factors for carotid plaque formation. In patients with well-controlled hypertension (average BP < 130/80 mmHg), the progression rate of carotid plaques showed no significant difference from that of non-hypertensive individuals. However, the progression of carotid plaques was significantly accelerated in patients with uncontrolled hypertension.

Keywords

hypertension carotid plaque carotid ultrasonography community research

References

[1] J. Fan and T. Watanabe, "Atherosclerosis: Known and unknown," Pathol. Int., vol. 72, no. 3, pp. 151–160, 2022, doi: 10.1111/pin.13202.

[2] S. Xu and S. Offermanns, "Endothelial lipid droplets drive atherosclerosis and arterial hypertension," Trends Endocrinol. Metab., 2024, doi: 10.1016/j.tem.2024.02.014.

[3] A. Al-Sharea, M. K. S. Lee, A. Whillas, D. L. Michell, W. A. Shihata, A. J. Nicholls et al., "Chronic sympathetic driven hypertension promotes atherosclerosis by enhancing hematopoiesis," Haematologica, vol. 104, no. 3, pp. 456–467, Mar. 2019, doi: 10.3324/haematol.2018.192898.

[4] M. Lu, L. Wu, P. Shi, S. Kang, L. Shi, and Y. Wu, "Hypertension and subclinical carotid atherosclerosis in a suburban general population in China," J. Hypertens., vol. 22, no. 9, pp. 1699–1706, 2004, doi: 10.1097/00004872-200409000-00013.

[5] H. Zhang, J. Du, H. Wang, H. Wang, J. Jiang, J. Zhao, and H. Lu, "Comparison of diagnostic values of ultrasound micro-flow imaging and contrast-enhanced ultrasound for neovascularization in carotid plaques," Exp. Ther. Med., vol. 14, no. 1, pp. 680–688, 2017, doi: 10.3892/etm.2017.4525.

[6] P. K. Whelton et al., "2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA guideline for the prevention, detection, evaluation, and management of high blood pressure in adults: a report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines," J. Am. Coll. Cardiol., vol. 71, no. 19, pp. e127–e248, 2018, doi: 10.1161/CIR.0000000000000596.

[7] E. Falk, "Pathogenesis of Atherosclerosis," J. Am. Coll. Cardiol., vol. 47, no. 8, pp. C7–C12, 2006, doi: http://doi.org/10.1016/j.jacc.2005.09.068.

[8] P. Libby, P. Ridker, and G. Hansson, "Progress and challenges in translating the biology of atherosclerosis," Nature, vol. 473, pp. 317–325, 2011, doi: 10.1038/nature10146.

[9] A. Rognoni, C. Cavallino, A. Veia, S. Bacchini, R. Rosso, M. Facchini et al., "Pathophysiology of atherosclerotic plaque development," Cardiovasc. Hematol. Agents Med. Chem., vol. 13, no. 1, pp. 10–13, 2015, doi: 10.2174/1871525713666141218163425.

[10] J. Hurtubise, K. McLellan, K. Durr, et al., "The different facets of dyslipidemia and hypertension in atherosclerosis," Curr. Atheroscler. Rep., vol. 18, p. 82, 2016, doi: 10.1007/s11883-016-0632-z.

[11] A. V. Sterpetti, "Inflammatory cytokines and atherosclerotic plaque progression: Therapeutic implications," Curr. Atheroscler. Rep., vol. 22, p. 75, 2020, doi: 10.1007/s11883-020-00891-3.

[12] B. Zhan, X. Huang, J. Wang, et al., "Association Between Lipid Profiles and Arterial Stiffness in Chinese Patients with Hypertension: Insights From the CSPPT," Angiology, vol. 70, no. 6, pp. 515–522, 2019, doi: 10.1177/0003319718823341.

[13] Y. G. Tedla, Y. Yano, M. Carnethon, and P. Greenland, "Association between long-term blood pressure variability and 10-year progression in arterial stiffness: the multiethnic study of atherosclerosis," Hypertension, vol. 69, no. 1, pp. 118–127, 2017, doi: 10.1161/HYPERTENSIONAHA.116.08427.

[14] L. Liberale and G. G. Camici, "The role of vascular aging in atherosclerotic plaque development and vulnerability," Curr. Pharm. Des., vol. 25, no. 29, pp. 3098–3111, 2019, doi: 10.2174/1381612825666190830175424.

[15] C. Nardin, M. Rattazzi, and P. Pauletto, "Blood pressure variability and therapeutic implications in hypertension and cardiovascular diseases," High Blood Press. Cardiovasc. Prev., vol. 26, pp. 353–359, 2019, doi: 10.1007/s40292-019-00339-z.

Copyright and License

Published in2026-05-23 09:15:30

DOI 10.70088/j49y7132

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Copyright: © 2025 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/license s/by/4.0/).

Copyright
Copyright © The Author(s), 2025. Published by SEMBE 2025

Journal Information

  • Vol. 4 (2025): 2025 International Conference on Agricultural Sciences, Economics, Biomedical and Environmental Sciences (SEMBE 2025)
  • 2026-05-23
  • ISSN: (Print) 3078-770X/ (Online) 3078-7718
  • Journal Homepage

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