Carotid Plaque, Intima Media Thickness, Cardiovascular Risk Factors, and Prevalent Cardiovascular Disease in Men and Women

Abstract

Background and Purpose-B-mode ultrasound is a noninvasive method of examining the walls of peripheral arteries and provides measures of the intima-media thickness (IMT) at various sites (common carotid artery, bifurcation, internal carotid artery) and of plaques that may indicate early presymptomatic disease. The reported associations between cardiovascular risk factors, clinical disease, IMT, and plaques are inconsistent. We sought to clarify these relationships in a large, representative sample of men and women living in 2 British towns. Methods-The study was performed during 1996 in 2 towns (Dewsbury and Maidstone) of the British Regional Heart Study that have an Ϸ2-fold difference in coronary heart disease risk. The male participants were drawn from the British Regional Heart Study and were recruited in 1978 -1980 and form part of a national cohort study of 7735 men. A random sample of women of similar age to the men (55 to 77 years) was also selected from the age-sex register of the general practices used in the original survey. A wide range of data on social, lifestyle, and physiological factors, cardiovascular disease symptoms, and diagnoses was collected. Measures of right and left common carotid IMT (IMT cca ) and bifurcation IMT (IMT bif ) were made, and the arteries were examined for plaques 1.5 cm above and below the flow divider. Results-Totals of 425 men and 375 women were surveyed (mean age, 66 years; range, 56 to 77 years). The mean (SD) IMT cca observed were 0.84 (0.21) and 0.75 (0.16) mm for men and women, respectively. The mean (SD) IMT bif were 1.69 (0.61) and 1.50 (0.77) mm for men and women, respectively. The correlation between IMT cca and IMT bif was similar in men (rϭ0.36) and women (rϭ0.38). There were no differences in mean IMT cca or IMT bif between the 2 towns. Carotid plaques were very common, affecting 57% (nϭ239) of men and 58% (nϭ211) of women. Severe carotid plaques with flow disturbance were rare, affecting 9 men (2%) and 6 women (1.6%). Plaques increased in prevalence with age, affecting 49% men and 39% of women aged Ͻ60 years and 65% and 75% of men and women, respectively, aged Ͼ70 years. Plaques were most common among men in Dewsbury (79% affected) and least common among men in Maidstone (34% affected). IMT cca showed a different pattern of association with cardiovascular risk factors from IMT bif and was associated with age, SBP, and FEV 1 but not with social, lifestyle, or other physiological risk factors. IMT bif and carotid plaques were associated with smoking, manual social class, and plasma fibrinogen. IMT bif and carotid plaques were associated with symptoms and diagnoses of cardiovascular diseases. IMT bif associations with cardiovascular risk factors and prevalent cardiovascular disease appeared to be explained by the presence of plaques in regression models and in analyses stratified by plaque status. Conclusions-IMT cca , IMT bif , and plaque are correlated with each other but show differing patterns of association with risk factors and prevalent disease. IMT cca ...

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

“…This is in accordance with the previous results concerning carotid arteries. 5,12,14 We did not find any previous studies evaluating only the possible association between SBP and plaques in either femoral arteries or aorta. Simon et al 13 studied the risk factors for plaques in carotid, aortic and femoral arteries and showed that the SBP of the study subjects increased with an increasing number of arteries with plaques.…”

“…33 Except for high SBP, high MBP was also associated with plaques in this study population. Apart from BP, male gender 5,12,28,30 and smoking [13][14]30 are well-established risk factors for atheromatous plaques. Carotid atherosclerosis measured by ultrasound appears to be associated with coronary artery disease 34 and to predict myocardial infarction.…”

“…3,6,8 Intima-media thickening has been suggested to represent an early phase of atherosclerosis preceding the development of plaques. 9 Only some studies have evaluated the association of hypertension 5,[10][11][12][13][14] with the occurrence of atherosclerotic plaques, and the mechanism linking hypertension with plaques remains poorly understood. In a recent study, carotid echogenic plaques were associated with increased aortic arterial stiffness measured by carotid-femoral pulse wave velocity.…”

Burden of carotid atherosclerosis in patients with stroke: relationships with circulating endothelial progenitor cells and hypertension

“…Previous studies have shown that patients with stroke have increased carotid IMT compared with controls. 10 Recent prospective studies have also demonstrated that individuals with a greater degree of carotid atherosclerosis are at an increased risk of stroke. 11,12 Our study has confirmed that patients with stroke have a greater degree of carotid atherosclerosis compared with controls.…”

Cruciferous and Total Vegetable Intakes Are Inversely Associated With Subclinical Atherosclerosis in Older Adult Women

“…The underlying cause of these cardiovascular disease subgroups is atherosclerosis, a complex multifactorial disorder of the arteries initiated by endothelial dysfunction, inflammation, and dyslipidemia 2, 3. Subclinical measures of atherosclerosis include common carotid artery intima‐media thickness (CCA‐IMT) and carotid atherosclerotic plaques, both of which have been shown to predict myocardial infarction and stroke 4, 5, 6…”