KONTRIBUSI HIPERTENSI TERHADAP ATEROSKLEROSIS ARTERI KAROTIS INTERNA PADA PASIEN PASCA STROKE ISKEMIK

Abstract

Background: Intracranial atherosclerosis was one of the etiology of ischemic stroke and could caused by several risk factors, including hypertension. Hypertension modulates the endothelial function which could be the cause of the occurrence of atherosclerosis. Increased intima media thickness of internal carotid artery is a marker of subclinical atherosclerosis and is a reflection of general atherosclerosis. Objective: To determine the contribution of hypertension to internal carotid artery atherosclerosis in post-ischemic stroke patients in Dr. Kariadi General Hospital, Semarang, Indonesia. Methods: A cross sectional study of 42 subjects post stroke ischemic with hypertension had done from June-August 2011. Inclusion criteria were post ischemic stroke patients one month to five years after onset, age 45–75 years. The exclusion criteria were patients with recurrent stroke, kidney and thyroid disfunction, steroid and estrogen users. The thickness of the tunica intima-media of the internal carotid artery was examined by carotid duplex ultrasound. Hypertension was determined by the onset of hypertension, blood pressure base on JNC VII and funduscopic examination. The correlation between hypertension and atherosclerosis were analyzed by Chi Square and Fisher Exact test. Results: The risk factors for internal carotid artery atherosclerosis were age ≥ 55 years, the prevalence ratio 16.8 (95%CI:1.67-186.7,p=0.019), and hypertension with grade 3 hypertensive retinopathy, the prevalence ratio 9.00 (95%CI:1.48-54.50,p=0.017). There were no association between gender, smoking history, diabetes mellitus, dyslipidemia, and obesity with internal carotid artery atherosclerosis (p>0.05). Conclusion: Hypertension was associated with internal carotid atherosclerosis in post ischemic stroke patients. Age ≥ 55 years and hypertension with grade 3 hypertensive retinopathy were contribution to the internal carotid atherosclerosis in post ischemic stroke patiens. Key words: Ischemic stroke, hypertension, hypertensive retinopathy, internal carotid atherosclerosis.