Hypertension is the most common cause of vessel injury. Hypertension or high blood pressure is a major risk factor in stroke. It has a stepping gradient in inducing vessel damage that lead to the vessels becoming stiff. In the process of hypertension-induced atherosclerosis,

blood vessels become smaller in size, rigid and lose compliance. Elevated blood pressure increases blood flow through the vessels. CP 868596 This induces shear stress elevation that leads to an increase in endothelial-derived relaxing factor (EDRF) production from endothelial cells. This includes nitric oxide, prostaglandin E and prostacyclin. These vasomotor activators induce the superoxide production and reduce the vessels permeability. The endothelial cells in the process of injury will release increased amounts of pro-inflammatory cytokines that will activate the leukocyte. This further induces

the elevation of vaso-active substances such as prostacycline and nitric oxide which eventually induce complete endothelial injury. The increase in intravascular pressure induces stress on the vessel wall in hypertension. This alters the vessel wall thickness through a process called vascular remodeling. Vascular remodeling as a response to high blood pressure leads to the reduction of the diameter of the blood vessel through hypertrophy (hypertrophic outer remodeling or hypertrophic inner remodeling) or through a eutrophic inner remodeling process. Change PD0325901 manufacturer in the common-carotid-artery intima–media thickness is believed to be an indicator of generalized atherosclerosis. It has also been adopted as an intermediate end point for determining cardiovascular morbidity and also as a surrogate end point to evaluate the success of lipid

lowering drug interventions [4] and [5]. High-resolution carotid ultrasonography has been used to obtain measurements of the thickness of the tunica intima and media of the carotid arteries. Studies in the western countries have shown not only cross-sectional correlations but also prospective correlations between common-carotid-artery intima–media thickness and the prevalence of cardiovascular and cerebrovascular disease science [1], [2] and [3]. There are still few studies showing an association between increased carotid-artery intima–media thickness and stroke in Asia, especially in Indonesia. In this study, we investigated the hypothesis that carotid-artery intima–media thickness is directly correlated with the incidence of stroke. The study subjects were patients in the Cipto Mangunkusumo National Hospital, Jakarta, Indonesia with age ranging from 31 to 75 years old. The patients were categorized into 2 groups, stroke and non stroke groups. There were 131 patients in the stroke group and 128 patients in the non-stroke group. The carotid arteries of all patients were evaluated using high-resolution B-mode ultrasonography using a cross-sectional methodology.