Introduction:
A key indicator of cardiovascular risk, especially in people with hypertension, is the carotid artery's intima-media thickness (IMT). This article focuses on how IMT and hypertension are related, how well IMT predicts cardiovascular events, and how antihypertensive medications affect the course of IMT.

Aim:
To search into the relationship between IMT and hypertension and evaluate how antihypertensive medication affects IMT in people with hypertension.

Material and methods:
A detailed analysis of the existing literature body served as the foundation for this investigation. Several electronic databases, including Embase, PubMed, Scopus, Web of Science, Cochrane Library, Frontiers, Taylor & Francis Online, Springer, and Elsevier, were searched systematically using pertinent keywords. Thirty articles were found to be eligible for review.

Results and discussion:
Increased IMT is closely linked to hypertension, suggesting that high blood pressure causes arterial wall thickening. Future cardiovascular events, including myocardial infarction and stroke, can be accurately predicted by elevated IMT. It has been demonstrated that antihypertensive medications, especially those that target the renin-angiotensin-aldosterone system, can effectively slow the progression of IMT. Improving patient outcomes requires early identification of subclinical atherosclerosis using IMT measurement and individualized treatment plans. To effectively manage hypertensive patients with elevated IMT, healthcare providers must work together.

Conclusions:
Reducing cardiovascular risk in hypertensive patients requires a multidisciplinary approach. Frequent IMT evaluation is useful for treatment planning and cardiovascular risk assessment. Furthermore, anesthesia professionals are essential to maintaining patient safety and maximizing pain control.