ObjectiveCarotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common carotid artery intima-media thickness (CCA-IMT) in a general population.MethodsWe examined 6524 participants aged 25–69 years in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. Plaques at the bifurcation and internal carotid arteries were evaluated. Mean CCA-IMT was measured in the near and far walls of the common carotid arteries.ResultsThe prevalence of minimal, moderate and severe plaque was 35.0%, 8.9% and 1.1%, respectively, and the mean CCA-IMT was 0.73 (SD 0.14) mm. Age, sex, smoking and type 2 diabetes mellitus (T2DM) were the strongest risk factors associated with plaque, followed by systolic blood pressure, total cholesterol, body mass index and family history of myocardial infarct. Low educational level was also strongly and independently associated with plaque. CCA-IMT shared the same risk factors except for a non-significant association with T2DM and family history of myocardial infarction (MI). Participants with T2DM had greater plaque prevalence, 2-fold higher in those <50 years and 17–30% greater in age groups 50–54 to 60–64, and more significant plaques (moderate or severe) were the difference in prevalence was 24% in age group 50–54 and ≥60% in older age groups, compared with non-T2DM.ConclusionsCarotid plaque and CCA-IMT have mostly common determinants. However, T2DM and family history of MI were associated with plaque but not with CCA-IMT. Greater prevalence and more severe plaques in individuals with T2DM raise the concern that with increasing prevalence of T2DM we may expect an increase in atherosclerosis and its consequences.

Background Ideal cardiovascular (CV) health by simultaneous presence of 7 ideal health metrics (blood pressure, cholesterol, glucose, smoking, BMI, physical activity and diet) has been defined by the American Heart Association. In the current study we investigated the association of a CV health score (range 0–14), on the extent and progression of carotid atherosclerosis, assessed as carotid intima-media thickness (cIMT) and total plaque area (TPA) by ultrasound at 5 years interval. Methods and Results A total of 219 participants (age 75.6±5.1) from the Age, Gene/Environment Susceptibility (AGES)-Reykjavik study were studied. Men with poor (low) CV health score had greater TPA than those with more optimal (high) score (61.5 (SD: 32.3), 44.4 (24.2) and 37.7 (23.2) mm2 for those with CV health score ≤ 6, 7–9 and ≥ 10 respectively, p<0.05). In linear analysis for men, log TPA was 0.088 mm2 (SE: 0.040 p<0.05) smaller for each additional point in the CV health score. CV health score was not associated with TPA in women, or cIMT in either sex. TPA increased in both sexes between visits. However, CV health score did not predict carotid atherosclerosis progression. Conclusions CV health score is associated with TPA in older men but not in women. Men with poor CV health score at the baseline visit had more extensive carotid atherosclerosis than those with better CV health score, although it did not predict the progression of carotid atherosclerosis.

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