Intima-Media Thickness of Femoral Arteries and Carotids among an Adult Hypertensive Nigerian Population: A Case-Control Study to Assess their Use as Surrogate Markers of Atherosclerosis

Background: Increased intima-media thickness (IMT) is an established and important surrogate marker for atherosclerosis. Intima-media thickening in the femoral arteries occur earlier and reflect the true extent of generalized atherosclerosis better than in the carotids. Aims: To study the ultrasound-detected morphological changes in the common femoral versus carotid artery wall. Patients and Methods: A case-control study design was used, with 61 adult hypertensive as cases and 61 age-, sex- and BMI-matched normotensive as controls. Variables were participants' characteristics, cardiovascular risk factors, and ultrasonographically evaluated IMT of the carotid and femoral arteries. Results: A total of 122 participants were studied. The mean femoral IMT in hypertensives and controls on the right and left was 0.63 +/- 0.07 mm vs. 0.52 +/- 0.06 mm [P < 0.0001] and 0.69 +/- 0.0 mm vs. 0.55 +/- 0.05 mm [P < 0.0001]. Also, the mean carotid IMT among hypertensives and controls on the right = 0.80 +/- 0.15 mm vs. 0.64 +/- 0.06 mm [P < 0.0001], and 0.91 +/- 0.22 mm vs. 0.65 +/- 0.06 mm [P < 0.0001] on the left. Significant correlation was observed between IMT and age (B = 0.006, P < 0.001 and B = 0.003, P < 0.001), hypertension (B = 0.205, P < 0.001 and B = 0.122, p<0.001), and duration of hypertension (B = 0.02, P < 0.001 and B = 0.006, P = 0.02) the femoral and carotid arteries respectively. Conclusion: The femoral and the carotid artery show similar significantly increased IMT in hypertensive adults. The femoral IMT appears to be a good surrogate marker of atherosclerosis among hypertensive Nigerians.