The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

Rundek, Tatjana; Gardener, Hannah; Della-Morte, David; Dong, Chuanhui; Cabral, Digna; Tiozzo, Eduardo; Roberts, Eugene; Crisby, Milita; Cheung, Kenneth; Demmer, Ryan T.; Elkind, Mitchell S.V.; Sacco, Ralph L.; Desvarieux, Moïse

doi:10.1016/j.atherosclerosis.2015.05.027

Cited by 54 publications

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“…We did not find associations with other traditional risk factors such as systolic blood pressure, race, and sex. 27–31 A few possibilities may account for these findings. This sample comprised predominantly young ethnic and racial minority participants in whom elevated blood pressure may not have yet manifested.…”

Section: Discussionmentioning

confidence: 99%

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

Jones

Rodriguez

Alcaide

et al. 2017

Southern Medical Journal

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Objectives The presence of atherosclerotic plaques in the carotid arteries is a strong predictor of cardiovascular disease (CVD). Research and data on CVD risk have been derived primarily from individuals aged 55 years or older, and assessment of CVD risk among young and middle-aged adults seldom has been studied. The use of ultrasonography to measure carotid intima-media thickness (IMT) and carotid plaque appears to have utility to detect subclinical atherosclerosis in asymptomatic adults. This study evaluated the presence of carotid plaque using ultrasonography among healthy young and middle-aged adults. Methods Participants were men and women recruited in Miami, Florida, and were 18 to 50 years old with no history of CVD. Participants underwent a general physical examination and a carotid artery ultrasonography to evaluate carotid IMT and carotid plaque. Results From a total of 173 participants with a mean age of 34 years (standard deviation 8.9), 21.0% (95% confidence interval [CI] 15.0–27.2) were identified as having carotid plaque. IMT values ranged from 0.49 to 1.03 mm, with a mean value of 0.70 mm (standard deviation 0.09). In multivariable logistic regression older age (adjusted odds ratio [AOR] 1.08, 95% CI 1.01–1.16, P = 0.024) and cigarette smoking (AOR 2.67, 95% CI 1.02–7.00, P = 0.045) were associated with plaque, after controlling for IMT (AOR 2.55, 95% CI 1.40–4.65, P = 0.002). Conclusions Traditional CVD risk factors such as those evaluated in this study may fail to provide adequate predictive value of carotid atherosclerosis in younger populations with no history of CVD, because the majority of traditional risk factors identified in previous research were not associated with carotid plaque in this young sample. Further research assessing nontraditional risk factors among asymptomatic individuals is required, and the evaluation of IMT as an intervention tool to detect CVD risk in these asymptomatic populations is warranted.

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Section: Discussionmentioning

confidence: 99%

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

Jones

Rodriguez

Alcaide

et al. 2017

Southern Medical Journal

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“…Presence of plaque was defined as a focal wall thickening or protrusion in the lumen more than 50% greater than the surrounding thickness. 19 cIMT was measured in areas without plaque and calculated as a composite measure of the near and the far walls of the CCA, bifurcation, and internal carotid artery (ICA) intima media thickness (IMT) of both sides of the neck, and expressed as a mean of the maximum measurements of the 12 carotid sites. We also examined IMT in the bifurcation and ICA exclusively and IMT in the CCA exclusively.…”

Section: Methods Study Population the Northern Manhattanmentioning

confidence: 99%

“…We also examined IMT in the bifurcation and ICA exclusively and IMT in the CCA exclusively. 19 Beta stiffness index was calculated as a ratio between natural log transformation of systolic blood pressure (SBP) 2 diastolic blood pressure (DBP) over STRAIN (ln[SBP 2 DBP]/STRAIN), where STRAIN was expressed as (systolic diameter 2 DD)/DD. 20 Blood pressure was measured in the right arm using a Dinamap Pro100 (Critikon Inc., Tampa, FL) automatic sphygmomanometer after the participants had rested for 10 minutes in a supine position.…”

Section: Methods Study Population the Northern Manhattanmentioning

confidence: 99%

Relationship between carotid arterial properties and cerebral white matter hyperintensities

et al. 2017

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Objective: Since arterial stiffness is a functional measure of arterial compliance and may be an important marker of cerebrovascular disease, we examined the association of carotid artery stiffness with white matter hyperintensity volume (WMHV) in a cross-sectional study of 1,166 strokefree participants.Methods: Carotid beta stiffness index (STIFF) was assessed by M-mode ultrasound of the common carotid artery and calculated as the ratio of natural log of the difference between systolic and diastolic blood pressure over STRAIN, a ratio of the difference between carotid systolic and diastolic diameter (DD) divided by DD. WMHV was measured by fluid-attenuated inversion recovery MRI. The associations of STIFF, DD, and STRAIN with WMHV were examined using linear regression after adjusting for sociodemographic, lifestyle, and vascular risk factors. Results:In a fully adjusted model, larger carotid DD was significantly associated with greater log-WMHV (b 5 0.09, p 5 0.001). STIFF and STRAIN were not significantly associated with WMHV. In adjusted analyses stratified by race-ethnicity, STRAIN (b 5 21.78, p 5 0.002) and DD (b 5 0.11, p 5 0.001) were both associated with greater log-WMHV among Hispanic participants, but not among black or white participants.Conclusions: Large carotid artery diameters are associated with greater burden of white matter hyperintensity (WMH) in this multiethnic population. The association between increased diameters, decreased STRAIN, and greater WMH burden is more pronounced among Hispanics. These associations suggest a potential important pathophysiologic role of extracranial large artery remodeling in the burden of WMH. Neurology ® 2017;88:2036-2042 GLOSSARY BMI 5 body mass index; CCA 5 common carotid artery; CI 5 confidence interval; cIMT 5 carotid intima media thickness; DBP 5 diastolic blood pressure; DD 5 diastolic diameter; FLAIR 5 fluid-attenuated inversion recovery; HDL 5 high-density lipoprotein; ICA 5 internal carotid artery; ICV 5 intracranial volume; IMT 5 intima media thickness; LDL 5 low-density lipoprotein; NOMAS 5 Northern Manhattan Study; OR 5 odds ratio; PWV 5 pulse wave velocity; SBI 5 silent brain infarction; SBP 5 systolic blood pressure; WMH 5 white matter hyperintensity; WMHV 5 white matter hyperintensity volume.

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“…Carotid intima‐media thickening (CIMT) and carotid plaque (CP) are considered to be surrogate subclinical markers of early atherosclerosis, are associated with stroke risk (Georgios et al., 2006; Rundek et al., 2015), and can predict the occurrence of ischemic cerebrovascular events (Prati et al., 2008). There is a study that found that increased common carotid artery stiffness is associated with ischemic stroke (Tsivgoulis et al., 2006).…”

Section: Introductionmentioning

confidence: 99%

Risk factors of carotid plaque and carotid common artery intima‐media thickening in a high‐stroke‐risk population

Wang

Zang

2017

Brain and Behavior

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IntroductionTo analyze the risk factors of carotid plaque (CP) and carotid common artery intima‐media thickening (CCAIMT) and the association between the risk factors and CP numbers and the side of the CCAIMT in a high‐stroke‐risk population.MethodsCarotid ultrasonography was conducted in 2025 participants with high stroke risk. Participants were divided into different groups according to the results of the ultrasound. The risk factors and blood biochemical indices were recorded.ResultsThe presence of CP and CCAIMT were 38.9% and 24.8% respectively. Multivariate logistic regression indicated that the risk factors of CP were age, high LDL‐C and FBG levels, male gender, stroke, diabetes, hypertension, and tobacco use. Compared with participants without CPs, the participants who were male, and older in age, with risk factors of tobacco use, diabetes, high LDL‐C levels, and a family history of hypertension were likely to have a single CP, whereas the participants with risk factors of tobacco use, diabetes, hypertension, male gender, older age, high LDL‐C levels, stroke and AF or valvulopathy were prone to have multiple CPs. The risk factors of CCAIMT were male gender, stroke, hypertension, diabetes, AF or valvulopathy, tobacco use and age. Compared with the N‐CCAIMT subgroup, the risk factors of left CCAIMT were tobacco use, diabetes, male gender, and age. The risk factors of right CCAIMT were male gender, high FBG levels, age, AF or valvulopathy. The risk factors of dual CCAIMT were high frequency of drinking milk, tobacco use, male gender, age, stroke, and hypertension.ConclusionThese findings revealed the risk factors of CP and CCAIMT, and an association between the risk factors and the CP numbers and the side of the CCAIMT.

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The relationship between carotid intima-media thickness and carotid plaque in the Northern Manhattan Study

Cited by 54 publications

References 43 publications

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

Subclinical Atherosclerosis Among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements

Relationship between carotid arterial properties and cerebral white matter hyperintensities

Risk factors of carotid plaque and carotid common artery intima‐media thickening in a high‐stroke‐risk population

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