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Multiple risk factor intervention reduces cardiovascular risk in hypertensive patients with echolucent plaques in the carotid artery . OBJECTIVE In a previously published randomized 6-year study we observed that multiple risk factor intervention reduced cardiovascular risk in high-risk hypertensive men , and that this effect was confined to patients with carotid artery plaques . Hypothetically , the underlying mechanism might have been a stabilization of echolucent , instable , rupture-prone plaques . The aim of the present study was to examine plaque characteristics by B-mode ultrasound in the previous intervention study , and also to investigate the relationship between plaque characteristics at baseline and cardiovascular events during the 6-year follow-up in the two randomization groups . METHODS High resolution B-mode ultrasound was used to characterize plaque echogenicity in four subgroups - dominantly echolucent , substantially echolucent , dominantly echogenic , and uniformly echogenic . RESULTS In the usual care group 17 of 32 ( 53 % ) patients with echolucent plaques at baseline suffered from a combined end-point ( any death or nonfatal myocardial infarction or nonfatal stroke ) during follow-up compared with seven of 28 ( 25 % ) patients in the intervention group ( P = 0.036 ) . The corresponding numbers in patients with echogenic plaques were n = 4/13 ( 31 % ) and n = 4/17 ( 24 % ) , respectively ( NS ) . In the usual care group 11 of 33 ( 33 % ) patients with no plaques suffered from a combined end-point during follow-up compared with 11 of 30 ( 37 % ) in the intervention group . CONCLUSION Our data indicate that the beneficial effect of the multiple risk intervention programme was confined to those patients with echolucent plaques . The data have to be confirmed with a large-scale trial .
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Intervention_Other
Multiple risk factor intervention
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Intervention_Physical
B-mode ultrasound
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Intervention_Physical
High resolution B-mode ultrasound
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Intervention_Control
usual care group
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Intervention_Control
usual care group
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Intervention_Physical
intervention group
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Intervention_Physical
multiple risk intervention programme
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Outcome_Physical
plaque characteristics
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Outcome_Physical
plaque characteristics
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Outcome_Physical
cardiovascular events
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Outcome_Physical
characterize plaque echogenicity
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Outcome_Physical
echolucent plaques
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Outcome_Mortality
death
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Outcome_Physical
nonfatal myocardial infarction or nonfatal stroke
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Outcome_Physical
echogenic plaques
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Outcome_Other
beneficial effect
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Participant_Condition
high-risk hypertensive men