What is the Prevalence of Low Health Literacy in European Union Member States? A Systematic Review and Meta-analysis.

BACKGROUND: Many studies have shown that low health literacy (HL) is associated with several adverse outcomes. In this study, we systematically reviewed the prevalence of low HL in Europe. METHODS: PubMed, Embase, and Scopus were searched. Cross-sectional studies conducted in the European Union (EU), published from 2000, investigating the prevalence of low HL in adults using a reliable tool, were included. Quality was assessed with the Newcastle-Ottawa Scale. Inverse-variance random effects methods were used to produce pooled prevalence estimates. A meta-regression analysis was performed to assess the association between low HL and the characteristics of the studies. RESULTS: The pooled prevalence of low HL ranged from of 27% (95% CI: 18-38%) to 48% (95% CI: 41-55%), depending on the literacy assessment method applied. Southern, Western, and Eastern EU countries had lower HL compared to northern Europe (ß: 0.87, 95% CI: 0.40-1.35; ß: 0.59, 95% CI: 0.25-0.93; and ß: 0.72, 95% CI: 0.06-1.37, respectively). The assessment method significantly influenced the pooled estimate: compared to word recognition items, using self-reported comprehensions items (ß: 0.61, 95% CI: 0.15-1.08), reading or numeracy comprehensions items (ß: 0.77, 95% CI: 0.24-1.31), or a mixed method (ß: 0.66, 95% CI: 0.01-1.33) found higher rates of low HL. Refugees had the lowest HL (ß: 1.59, 95% CI: 0.26-2.92). Finally, lower quality studies reported higher rates of low HL (ß: 0.56, 95% CI: 0.06-1.07). DISCUSSION: We found that low HL is a public health challenge throughout Europe, where one in every three to almost one in every two Europeans may not be able to understand essential health-related material. Additional research is needed to investigate the underlying causes and to develop remedies. PROSPERO REGISTRATION: CRD42019133377.

Ivabradine improves all aspects of quality of life assessed with the 36-item short form health survey in subjects with chronic ischemic heart disease compared with beta-blockers.

No published studies have evaluated quality of life (QOL) with the 36-item Short Form Health Survey (SF-36) in subjects with chronic stable angina pectoris (CSAP). We evaluated whether a 1-month treatment with 10 mg ivabradine (IVA) or ß-blockers (bisoprolol 2.5 mg/day, carvedilol 12.5 mg/day, atenolol 50 mg/day) improves the QOL in patients with CSAP. The SF-36 was administered to 238 patients randomized in two groups. QOL and heart rate (HR) results after 1 month of therapy with IVA and ß-blockers (T1) were compared with basal values (T0). Treatments in both groups significantly reduced HR (-11 bpm at T1 compared with T0 in the IVA group, -7 bpm at T1 compared with T0 in the ß-blocker group), but IVA demonstrated a more significant (p < 0.001) reduction in HR than ß-blocker treatment (p < 0.01). We observed a significant improvement in all QOL dimensions in the group treated with IVA, in particular in the sections regarding physical functioning, physical role, and general health (p < 0.001). In the group treated with ß-blockers, we found statistically significant improvement only in the physical functioning and physical role sections (p < 0.01). With ß-blocker treatment, many questionnaire sections showed no statistically significant improvement (body pain, social functioning, emotional role, and mental component summary). IVA treatment significantly improves all aspects of QOL in patients with CSAP, unlike ß-blocker treatment. This improvement is associated with a greater reduction in HR.

Left ventricular noncompaction cardiomyopathy.

Isolated left ventricular noncompaction (ILVNC) is a congenital abnormality in the structure of ventricular tissue due to amorphogenetic defect during embryogenesis. This rare entity can be easily diagnosed by the characteristic appearance of prominent trabeculations and deep inter-trabecular spaces. Clinical manifestations of this disease include benign and malignant ventricular arrhythmia, congestive heart failure signs, cardio-embolic events (stroke), mitral and pulmonary valve incompetence, and reduced global ventricular systolic function. We present the case report of a 58-year-old man with ILVNC.

[Bilateral and monolateral dolichoarteriopathies (Kinking, Coiling, Tortuosity) of the carotid arteries and atherosclerotic disease. An ultrasonographic study]. / Dolicoarteriopati (Kinking, Coiling, Tortuosità) delle arterie carotidi bilaterali e monolatrali e malattia aterosclerotica. Studio ultrasonografico.

BACKGROUND: The aim of this study, performed in outpatients, is to evaluate, using echo color Doppler examination, atherosclerotic lesions of extracranial carotid arteries in subjects with bilateral, and monolateral dolichoarteriopathies. METHODS: A total of 316 subjects, 77 with bilateral and 239 with monolateral dolichoarteriopathies, were studied. Patients were divided into: 79 subjects without cardiovascular risk factors and 237 subjects with cardiovascular risk factors (98 with arterial hypertension alone, 85 with arterial hypertension associated with other cardiovascular risk factors, 54 with hypercholesterolemia, diabetes, cigarette smoking, alone or associated). Myointimal thickness, as a mean of 5 measurements at common carotid level, 2-3 cm from flow-divider and plaques as a focal thickness =/> 2 mm, were evaluated. RESULTS: In 77 patients with bilateral dolichoarteriopathies, compared to 239 patients with monolateral dolichoarteriopathies, there were no differences in myointimal thickening, and in the prevalence of carotid plaques; no difference was observed between sexes. Both in subjects with and without cardiovascular risk factors myointimal thickness and carotid plaques didn't show any significant differences in bilateral compared with monolateral dolichoarteriopathies. CONCLUSIONS: In conclusion, bilateral, compared with monolateral, dolichoarteriopathies of the carotids, do not seem to be a consequence of atherosclerotic lesions.

A 2D Echo color-Doppler study of the extracranial carotid arteries in borderline arterial isolated systolic hypertension.

BACKGROUND: The aim of this study was to evaluate the prevalence of atherosclerotic carotid lesions in isolated systolic borderline arterial hypertension by 2D echo color-Doppler and effect of night-time pressure fall by ambulatory blood pressure monitoring. METHODS: Outpatients from January 1992 to December 1998 were examined. One hundred and twenty normotensive control subjects and 99 isolated systolic borderline untreated hypertensives were studied, based on blood pressure fall were divided into dippers, with nocturnal systolic and/or diastolic blood pressure fall of >10%, and non dippers. Subjects with ischemic heart disease, valvulopathies, heart failure, renal insufficiency, cerebrovasculopathies, hypercholesterolemia (total cholesterol >200 mg/dl) and diabetes. Normotensives and hypertensives were homogenous for cardiovascular risk factors. A thickness of =/> 0.95 mm, calculated as a mean of 5 measurements of the common carotid artery, 2-3 cm from the carotid bifurcation, was considered a sign of myointimal thickening, and the plaque as a focal thickening of =/> 2 mm, based on echogenic characteristics and site. RESULTS: Compared to normotensives, isolated systolic borderline hypertensives, showed carotid arteries with an intima-media thickening (p=0.002) with one or more plaques (p=0.0001) much more frequently, while normal carotid arteries (p=0.0001) were less frequent. In normotensives, like in hypertensives, the prevalence of vasal lesions was not significantly different in dippers compared with non dippers. Plaques were most often localized at level of the common carotid and lesions were hard. CONCLUSIONS: The conclusions is drawn that isolated systolic hypertension is the sign of major vascular atherosclerotic lesions. The night-time pressure fall does not affect the importance of the lesions.

[Dolichoarteriopathies (kinking, coiling, tortuosity) of carotid arteries and atherosclerotic disease: an ultrasonographic study]. / Dolicoarteriopatie (kinking, coiling, tortuosità) delle arterie carotidi e malattia aterosclerotica: studio ultrasonografico.

The clinical significance of the dolichoarteriopathies (kinking, coiling and tortuosity) of the extracranial carotid arteries, their prognosis and etiopathogenesis have not yet been clearly defined. The aim of this study was to evaluate, by echo-color-Doppler, atherosclerotic lesions of carotids in subjects with, compared to those without dolichoarteriopathies. A total of 1220 subjects (aged 25-89 years), 316 with and 904 without dolichoarteriopathies, were studied. Patients were divided into 325 subjects without cardiovascular risk factors and 895 subjects with cardiovascular risk factors (352 with arterial hypertension alone, 298 with arterial hypertension associated with other cardiovascular risk factors, 245 with hypercholesterolemia, diabetes, cigarette smoking, alone or associated). Moreover, the study was performed specifically in a subgroup of 352 subjects with arterial hypertension without other cardiovascular risk factors. Myointimal thickness, as a mean of 5 measurements at the level of the common carotid, 2-3 cm from the flow-divider and plaques as a focal thickness > or = 2 mm, classified on the basis of echogenic characteristics (hard, fibrous, mixed, soft, hemorrhagic) and seat (bifurcation, common, internal and external carotid) were evaluated. In 316 patients with dolichoarteriopathies, compared to 904 patients without dolichoarteriopathies there were no differences in myointimal thickening (NS), the prevalence of carotid plaques was lower (p = 0.004) and there was no difference (NS) regarding ultrasonic characteristics (more frequently hard and less frequently fibrous, mixed and soft) and localization of plaques (more frequently at the level of the common and bifurcation and less frequently at the level of the internal and external carotid). In subjects without cardiovascular risk factors, myointimal thickness and carotid plaques did not show any significant differences (NS) in the group with compared to the without dolichoarteriopathies. On the contrary, either in subjects with cardiovascular risk factors, or in the subgroup with hypertension alone, myointimal thickening was equally represented (NS), while carotids with plaques were significantly less frequent (p = 0.002; p = 0.01) in the group with, compared to that without dolichoarteriopathies. In conclusion, dolichoarteriopathies of the carotids do not seem to be a consequence of atherosclerotic lesions but in the presence of cardiovascular risk factors or hypertension alone they may even prevent plaque formation.

[White-coat arterial hypertension and stable borderline essential arterial hypertension. An ultrasonic study of the carotid arteries]. / Ipertensione arteriosa da camice bianco ed ipertensione arteriosa essenziale borderline stabile. Studio ultrasonografico delle arterie carotidi.

BACKGROUND: This study was designed to explore atherosclerotic lesions of the extracranial carotid arteries in patients with white-coat hypertension. METHODS: Using high resolution B-mode echography of the extracranial carotid arteries we examined 45 patients with white-coat hypertension compared with 60 normotensive subjects and 95 patients with essential arterial stable borderline hypertension. We considered abnormally high any intimal-medial thickness of > or = 0.95 mm, calculated as the mean of 5 measurements from the common carotid artery at 2-3 cm from the flow divider; and we called plaque any focal thickening of > or = 2 mm classified echographically as hard, fibrous, mixed, soft, or haemorrhagic, or in terms of lesion sites, e.g., common carotid, carotid bifurcation, or internal and external carotid. RESULTS: In patients with white-coat hypertension, compared to normotensive controls, we found the same prevalence of normal carotid vessels with intimal-medial thickening and one or more plaques; whereas compared to patients with essential arterial stable borderline hypertension we found a significantly lower prevalence of carotid vessels with intimal-medial thickening (p = 0.005) and one or more plaques (p = 0.02), plus a significantly higher prevalence of normal carotids (p = 0.001). The most frequent site of plaque formation was the common carotid and bifurcation; less so the internal and external carotid arteries. The most common type was the hard plaque; less common were fibrous, mixed and soft plaques. CONCLUSIONS: In conclusion, unlike stable hypertension, white-coat hypertension in patients with clinical stable borderline hypertension is apparently associated with low risk of vascular lesions, practically to the same level as normotensive subjects.

[Dolichoarteriopathy (kinking, coiling,tortuosity) of the carotid arteries and cardiovascular risk factors]. / Dolicoarteriopatie (kinking, coiling, tortuosità) delle arterie carotidi e fattori di rischio cardiovascolare.

BACKGROUND AND AIMS: The clinical significance of dolichoarteriopathies (kinking, coiling, tortuosity) and their prognosis have not yet been clearly defined. A study was performed in outpatients in order to evaluate the cardiovascular risk factors of dolichoarteriopathies. METHODS: A total of 1220 subjects (620 males and 600 females, aged between 25 and 89 years old) were examined using color Doppler ultrasonography of the extracranial carotid arteries with an Acuson 128 XP-5 scan and 7 MHz linear probe. The reason for the test was the presence of clinical symptoms or cardiovascular risk factors. The risk factors studied included: arterial hypertension [systolic (> 140 mmHg) and/or diastolic arterial pressure (> 90 mmHg)], hypercholesterolemia (total cholesterol > 200 mg/dl), diabetes mellitus, cigarette smoking. Patients were divided as follows: patients with arterial hypertension alone, patients with arterial hypertension associated with other cardiovascular risk factors (hypercholesterolemia, diabetes mellitus, smoking), patients with other cardiovascular risk factors (hypercholesterolemia, diabetes mellitus, smoking), patients without risk factors. RESULTS: In 316 (25.9%) patients with dolichoarteriopathies, arterial hypertension alone was present in 98 (31%), arterial hypertension associated with other cardiovascular risk factors in 85 (26.3%) and other cardiovascular risk factors in 54 (17%), whereas 75 (25%) did not present cardiovascular risk factors. In the 904 subjects without dolichoarteriopathies, arterial hypertension alone was present in 254 (28%), arterial hypertension associated with other cardiovascular risk factors in 213 (23.6%) and other cardiovascular risk factors in 191 (21.1%), whereas 241 (27.2%) did not present cardiovascular risk factors. In 316 subjects with dolichoarteriopathies, cardiovascular risk factors were equally present in the two sexes without statistically significant differences. In cases with kinking and tortuosity, cardiovascular risk factors were equally present in the two sexes, whereas colling was more frequently associated with arterial hypertension alone in males and with arterial hypertension associated with other risk factors in females, showing a statistically significant difference. CONCLUSIONS: The findings of this study reveal that the presence of risk factors in patients with dolichoarteriopathies is comparable to that in subjects without dolichoarteriopathies. Also in the three types of dolichoarteriopathies (kinking, coiling and tortuosity), cardiovascular risk factors were equally present. Therefore, these results appear to lay the role of arterial hypertension or other cardiovascular risk factors in the genesis of diolichoarteriopathies open to question.

[Dolicho-arteriopathies (kinking, coiling, tortuoosity) of the carotid arteries: study by color Doppler ultrasonography]. / Dolicoarteriopatie (kinking, coiling, tortuosità) delle arterie carotidi: studio con esame eco color Doppler.

BACKGROUND: This work aimed to study extracranial carotid dolichoarterial disease in outpatients using color Doppler ultrasonography. METHODS: A total of 1220 outpatients, 620 males and 600 females, aged between 25 and 89 years old, were enrolled in the study. Subjects were divided into three groups according to age: under 60, between 60 and 70, over 70. Color Doppler ultrasonography was performed on the extracranial carotid using Acuson 128 XP/5 ultrasonograph and linear 7 MHz probe. Reference was made to Weibel and Field's classification for kinking, coiling and tortuosity for the classification of dolichoarterial disease. RESULTS: Of the 1220 subjects examined, 316 (25.9%) presented dolichoarterial disease, 126 males (39.9%) and 190 females (60.1%) with a male/female ratio of 1:1.5. Of the 316 cases of dolichoarterial disease, 171 (54.1%; 14% of the patients examined) showed kinking, 36 (11.4%; 2.9% of the patients examined) showed coiling, 109 (34.5%; 8.9% of the patients examined) showed tortuosity. Females were predominantly affected by kinking (male/female ratio: 1:1.8) and coiling (male/female ratio: 1:1.8), whereas the two sexes were equally affected by tortuosity (male/female ratio: 1:1). 76 out of 387 subjects (19.6%) presented dolichoarterial disease in the under-60 group, 128 out of 441 subjects (29.3%) in the 60-70-year-old group, and 112 out of 392 subjects (28.6%) in the over-70 group. The prevalence of dolichoarterial disease remained stationary after the age of 70, as the result of different findings in the two sexes, but continued to increase in males, while it diminished in females. This trend was clearly evident for kinking and coiling, whereas the prevalence of the two sexes was comparable with regard to tortuosity, slightly higher in females under the age of 70 and slightly higher in males after the age of 70. Of the 316 cases of dolichoarterial disease diagnosed, 297 (94%) were localised at the level of the internal carotid artery, with a predominance for the left (47.8%) artery compared to the right (22.1%), 14 (4.4%) at the level of the external carotid artery and 5 (1.6%) affecting the common carotid. Dolichoarterial disease was monolateral in 239 subjects (75.6%) and bilateral in 77 (24.4%). Of the bilateral cases, only one affected the common carotid, 76 the internal carotid with much higher presence of kinking and coiling compared to tortuosity. As far as concerns the site of dolichoarterial disease, no difference was observed between the sexes. CONCLUSIONS: In conclusion, non-invasive color Doppler ultrasonography, which is easily repeatable, can provide useful data for the morphological evaluation of dolichoarterial disease. Further studies in large populations which will enable the anatomofunctional aspects obtained using color Doppler ultrasonography to be correlated with clinical symptoms and possible effects on the central nervous system are now required for an improved clinical and prognostic assessment of dolichoarterial disease.

[White coat arterial hypertension and isolated systolic arterial hypertension: ultrasonography of the carotid arteries]. / Ipertensione arteriosa da camice bianco ed ipertensione arteriosa sistolica isolata: studio ultrasonografico delle arterie carotidi.

BACKGROUND: The prognosis of white coat hypertension is uncertain. The aim of this study was to evaluate the prevalence of atherosclerotic carotid lesions in subjects with white coat hypertension and clinical isolated systolic hypertension using 2D echo-color-doppler procedure. MATERIALS AND METHODS: Patients were initially selected through the sphygmomanometric measurement of blood pressure and subsequently through 24-hour blood pressure monitoring. Fifty-four subjects with white coat hypertension were studied in comparison with either 60 normotensive subjects or 116 sustained isolated systolic arterial hypertensives. All patients underwent high-resolution B-mode echotomography of both carotid arteries, which made it possible to assess myointimal thickening and plaques. A thickness of > or = 0.95 mm, calculated as the mean of 5 measurements of the common carotid artery, 2.3 cm from the flow divider, was considered a sign of myointimal thickening, while plaques were represented by a focal thickening of > or = 2 mm, based on echogenic characteristics (hard, fibrous, mixed, soft and hemorrhagic) and site (common carotid, bifurcation, internal and external carotid). RESULTS: Normal carotid arteries, carotid arteries with myointimal thickening, or carotid arteries with at least one plaque, were similar in subjects with white coat hypertension and in normotensives. Instead, as compared with subjects with white coat hypertension, sustained hypertensives showed a pattern of intimal-medial thickening (p = 0.04) with-one or more plaques (p = 0.005) on a much more frequent basis, while normal carotid arteries were less frequent (p = 0.0001). Plaques were most often localized at the common carotid artery and bifurcation and, less frequently, at the internal and external carotid arteries. Most often, the lesions were hard, less fibrous, mixed and soft. CONCLUSIONS: White coat hypertensives with clinical isolated systolic hypertension may represent a low-risk group. Long-term prospective studies are required in order to obtain a definitive prognosis of white coat hypertension.

[White coat arterial hypertension: ultrasonographic study of the carotid arteries]. / Ipertensione arteriosa da camice bianco: studio ultrasonografico delle arterie carotidi.

The prognosis of white coat hypertension is uncertain. The aim of this study was to evaluate the prevalence of atherosclerotic carotid lesions in subjects with white coat hypertension. Compared to both 75 normotensives, and 150 sustained essential arterial hypertensives, 65 subjects with white coat hypertension were studied. Normotensives and hypertensives were divided into dippers, with nocturnal systolic and/or diastolic blood pressure fall of > 10%, and non-dippers. A thickness of > or = 0.95 mm, measured at the level of the common carotid artery, 2-3 cm from flow divider, was considered a sign of myontimal thickening. Plaque was considered as a focal thickening of > or = 2 mm, based on echogenic characteristics and site. Normal carotid arteries, or with myointimal thickening, or with one or more plaques, were similar in subjects with white coat hypertension and normotensives. Compared to subjects with white coat hypertension, sustained hypertensives much more frequently showed a pattern of intima-media thickening (p = 0.04) with one or more plaques (p = 0.01), while normal carotid arteries were less frequent (p = 0.0001). Among white coat hypertensives, dippers showed the same prevalence of normal carotid arteries and carotid lesions as normotensives. In non-dippers sustained hypertensives, compared to dippers, carotid with one or more plaques (p = 0.001) were significantly more frequent, while normal carotid arteries (p = 0.005) were less frequent. Plaques were more often localized at the level of the common carotid artery and bifurcation, and less frequently at the level of the internal and external carotid arteries; more often the lesions were hard, less fibrous, mixed and soft. In conclusion, white coat hypertensives may represent a low risk group. Long-term prospective studies are required to define the prognosis of white coat hypertension.

[Ultrasonography of the carotid arteries in mild-to-moderate essential arterial hypertension and isolated systolic arterial hypertension]. / Studio ultrasonografico delle arterie carotidi nell'ipertensione arteriosa essenziale lieve-moderata e nell'ipertensione arteriosa sistolica isolata.

The aim of this study was to evaluate the prevalence of atherosclerotic carotid lesions in arterial hypertension by 2D echo-color Doppler and the effect of night-time pressure fall by ambulatory blood pressure monitoring. One hundred and eighty-two subjects were studied: 60 normotensive control subjects, 60 mild-moderate essential hypertensives and 62 isolated systolic hypertensives. Hypertensive subjects were divided into two groups on the basis of night-time pressure fall (Group 1 > 10% and Group 2 < 10%). Thickness > or = 0.95 mm was considered a sign of intima-media thickening, and the plaque as a focal thickening of > or = 2 mm, based on echogenic characteristics (hard, fibrous, mixed, soft and haemorrhagic) and site (common carotid, bifurcation, internal and external carotid). Compared to normotensives, mild-moderate essential hypertensives, much more frequently, showed a pattern of intima-media thickening (p = 0.025) with one or more plaques (p = 0.0025), while normal carotid arteries (p = 0.0002) were less frequent. In isolated systolic hypertensives the prevalence of vasal lesions was not significantly different from that observed in mild-moderate hypertensives. In Group 2 of mild-moderate hypertensive subjects, carotids with one or more plaques (p = 0.02) were significantly more frequent compared to Group 1, while normal carotids (p = 0.04) were less frequent. Plaques were more often localized at the level of the common carotid artery and at the bifurcation and less frequently at the level of the internal and external carotid arteries; more often the lesions were hard, less fibrous, mixed and soft.(ABSTRACT TRUNCATED AT 250 WORDS)

[High-resolution ultrasonographic study of atherosclerotic lesions of the carotid arteries in borderline essential arterial hypertension]. / Studio ecotomografico ad alta risoluzione delle lesioni aterosclerotiche delle arterie carotidi nella ipertensione arteriosa essenziale borderline.

BACKGROUND: High resolution echotomographic study of the carotid arteries allows the examination of the arterial wall and the resulting alterations from different factors. Aim of the present study is to evaluate the atherosclerotic lesions of the extracranial carotid arteries wall in subjects with essential borderline arterial hypertension, pharmacologically untreated. The selection of the patients was made, at first, by means of sphigmomanometric measurement of blood pressure and successively by means of 24-hour blood pressure monitoring. METHODS: We studied: 59 subjects with borderline essential hypertension with casual systolic arterial pressure between 140 and 160 mm Hg and/or diastolic between 90 and 95 mm Hg and increased ambulatorial pressure; 11 subjects with white coat hypertension with casual systolic pressure between 140 and 160 mm Hg and/or diastolic between 90 and 95 mm Hg with normal ambulatorial pressure; 30 normotensive subjects with casual blood pressure < 140/90 mm Hg and normal ambulatorial pressure. Borderline hypertensive subjects were divided in two groups: Group 1 with sensible fall of blood pressure values, from day to night, more than 10% (14.3% systolic and 14.5% diastolic), and Group 2 with reduced nocturnal blood pressure fall, lesser than 10% (3.8% systolic, 2.7% diastolic). All the patients underwent high-resolution B-mode echotomography of both carotid arteries, which consented the evaluation of the myointimal thickening, of the atherosclerotic plaques with their echogenic characteristics and seat. A thickness > or = 0.95 mm Hg was considered as myointimal thickening, while a thickness > or = 2 mm was considered as plaque. RESULTS: In 59 borderline hypertensive subjects, compared with normotensive subjects, it was more frequent the detection either of myointimal thickening (p < 0.01) or subjects with plaques (p < 0.05), or subjects with more than one plaque (p < 0.05). In those subjects with white coat hypertension, it was detected a prevalence of myointimal thickening and plaques identical to that of normotensive subjects and lesser compared with borderline hypertensive subjects, not statistically meaningful. In those hypertensive subjects with reduced nocturnal blood pressure fall (Group 2), compared with Group 1, it was significatively more frequent the detection of myointimal thickening (p < 0.01), of subjects with plaques (p < 0.01) and subjects with more than one plaque (p < 0.05). There were no meaningful differences either among hypertensive and normotensive subjects or between those two sub-groups of hypertensive subjects for what concerns seat and echogenic characteristics of the plaques: the more frequent localization was at level of the common carotid artery and bifurcation, and less frequently at level of internal and external carotid artery. More frequently "hard" plaques and less frequently "fibrous", "mixed" and "soft" plaques were found. CONCLUSIONS: In conclusion, the results of our investigation document the role of the increase of the blood pressure, even of mild entity like in borderline essential hypertension, in determining atherosclerotic lesions of the carotid arterial wall, and the usefulness of both the echotomographic study, that shows such lesions, and of the ambulatory monitoring, that allows a better selection of hypertensive patients, to study and identify hypertensive subjects at minor or major risk.