Atherosclerotic Disease in the Femoral Artery in Hypertensive Patients at High Cardiovascular Risk

The Value of Ultrasonographic Assessment of Intima-Media Thickness and Plaque Occurrence

Suurkula, Madis
Fagerberg, Bjorn
Wendelhag, Inger
Agewall, Stefan
Wikstrand, John.

Received August 17, 1995; revision accepted February 2, 1996;
From the Department of Clinical Physiology (M.S.), Wallenberg Laboratory for Cardiovascular Research (I.W., J.W.), on behalf of the Risk Intervention Study (RIS) Group and the Department of Medicine (B.F., S.A.), Goteborg University, Sahlgrenska University Hospital, Gothenburg, Sweden.
Correspondence to Bjorn Fagerberg, MD, Department of Medicine, Goteborg University, Sahlgrenska University Hospital, S-413 45 Gothenburg, Sweden.

Arteriosclerosis, Thrombosis, & Vascular Biology 16(8):p 971-977, August 1996.

The aim of the present investigation was to examine the occurrence of ultrasound-assessed morphological changes in the right common femoral artery and relate these findings to the ankle-arm index and to symptoms of lower-extremity arterial disease in hypertensive men at high cardiovascular risk (n = 143). Comparisons were made with a healthy reference group consisting of age-matched men at low risk (n = 46). The results showed that it was possible to obtain high-quality measurements of intima-media thickness in about 80% of all men and that the intraobserver variability was satisfactory (14%). A normal mean intima-media thickness was defined, using data from the low-risk group. Plaque occurrence and mean intima-media thickness in the right common femoral artery were significantly associated with ankle-arm index both in the right and left leg. There were more and larger plaques, as well as thicker mean and maximum intima-media complexes, in the high-risk group than in the low-risk group. In the high-risk group, 11% suffered from symptoms of right lower-extremity artery disease, 20% had an ankle-arm index less or equal to 0.9, 62% had moderate or large plaques (compared with 28% in the low-risk group, P < .001), and 77% had an enlarged intima-media complex. The cumulative frequency of signs of atherosclerosis in the right leg was 81% among the 110 patients in whom complete results from all examinations were available. Our conclusion is that ultrasound measurement of the intima-media thickness of the common femoral artery is a valuable method to evaluate morphological changes related to atherosclerotic disease in the lower extremity. (Arterioscler Thromb Vasc Biol. 1996;16:971-977.)