Hypertensive patients often present with carotid atherosclerosis, and especially those with left ventricular hypertrophy (LVH) are known to have twice the prevalence of carotid atheroma. The aims of this study were to evaluate the changes in the severity of carotid atherosclerosis and left ventricular (LV) mass by control of blood pressure (BP) and hyperlipidemia in hypertensive patients.

A total of 87 treated hypertensive patients who had been diagnosed as stage 2 hypertension on Joint National Committee 7 classification in past 1 year or LVH on electrocardiographic criteria were enrolled. Both at baseline and the end of study, repetitive measurements of carotid intima-media thickness (IMT) and LV mass indexed by body surface area were performed. Measurement of carotid IMT was conducted at bilateral sides of distal common carotid artery.

After the follow-up period of mean 16-months, there were significant lowering in systolic and diastolic BP, respectively (144.6 ± 19.2 to 131.3 ± 13.6 mm Hg, p < 0.001; 87.5 ± 11.3 to 79.6 ± 9.4 mm Hg, p < 0.001). Carotid IMT showed no significant change (0.75 ± 0.18 to 0.76 ± 0.18 mm, p = 0.310). Although there was significant reduction in LV mass index (107.9 ± 22.0 to 101.0 ± 18.4 g/m², p < 0.001), it was not correlated with the changes in carotid IMT (r = 0.141, p = 0.197).

Anti-hypertensive therapy combined with statin if indicated did not show significant reduction in atherosclerotic burden of carotid artery, but it seemed to prevent further progression in hypertensive patients. Decrement in LV mass achieved by BP control was not correlated with changes in carotid IMT.