Renal resistive index and carotid resistive index markers of early cardiovascular damage in hypertensive patients

Abstract

Introduction. Resistive index (RI) is an useful tool for the evaluation of circulatory resistance and the presence of atherosclerosis with the use the Doppler ultrasound exam, but differences of the RI among various vascular beds have not been fully elucidated. So we decided to evaluate the relationship between renal and carotid artery RI and to compare the clinical implication and the potential use of these two parameters for an early detection of cardiovascular damage in the hypertensive patients. Materials and methods. The article is based on international publication data and on-line materials. Discussion results. Various studies showed a positive correlation between, pulse pressure (PP), and serum glucose level were positively correlated in the same time diastolic blood pressure (DBP) and creatinine clearance were negatively correlated with the RI of the interlobar arteries. It was found a positive correlation of sex (male) and PP, whereas DBP correlated negatively with the RI of the common carotid artery (CCA). The renal RI of was positively Associated with the carotid RI, even after adjustment for major cardiovascular risk factors. An particularly interesting fact was correlation between CCA RI and age, systolic blood pressure, heart rate, carotid intima-media thickness (IMT), left ventriclemass index (LVMI), and the negative correlation of the diastolic blood pressure and ankle brachial index (ABI). Subjects with high values of the carotid RI showed a higher rate of left ventricular hypertrophy and peripheral artery disease (increased IMT, carotid plaques and lower ABI) compared with those with low RI. The analysis of multiple clinical trials revealed that age, systolic and diastolic blood pressure and LVMI independently influence carotid RI and have a good correlation with values of the renal RI in the hypertensive patients. Conclusion: The results of various clinical trials suggest that the renal RI of and carotid RI increase in parallel in a certain manner. On the other side, risk factors for the increase of RI of the carotid and renal arteries have a partially differet manner, suggesting that specific control of particular risk factors may also be necessary in the prevention of vascular damage in each vascular bed. So we can draw the conclusion that the cuantification of these two parameters in complex could be particularly useful in the prediction of the cardiovascular damage, provide an accurate estimation of the global cardiovascular risk and an early prophylactic intervention for the prevention of cardiovascular damage in the large and heterogenic group of the hypertensive patients.