Relation of Intima-Media Thickness to Atherosclerotic Plaques in Carotid Arteries

Abstract

This study examined the relation between arterial wall thickness and local atherosclerosis in the carotid arteries (CAs) and their specific risk factors. B-mode ultrasonography of the CAs was performed in a cohort of 516 men and 756 women aged 59 to 71 years who had been recruited for the European Vascular Aging Study. Ultrasound examination included measurement of intima-media thickness of the common CA (CCA) and the sites of plaque in the internal CA and bifurcations. Significant associations between increases in CCA intima-media thickness and both the presence and severity of atherosclerotic plaque were found in men and women. Examination of specific risk factors for increases in CCA intima-media thickness in the presence of plaque showed that, after adjustment for sex, both ultrasound measurements were independently related to age, body mass index, hypertension, and ever smoking (versus never smoking). Diabetes and current smoking were associated with intima-media thickness only, whereas hypercholesterolemia was related to plaque only. However, when subjects who were taking lipid-lowering drugs were excluded, lipoproteins and apolipoproteins were more consistently related to intima-media thickness than to plaque. In subjects free from any antihypertensive treatment, both intima-media thickness and plaques were independently associated with systolic blood pressure. After adjustment for sex and other risk factors, the odds ratio for having at least one plaque associated with a 0.10-mm increase in CCA intima-media thickness was 1.18 (95% confidence interval, 1.05 to 1.32). In this relatively aged population, increases in intima-media thickness as measured in the CCAs were clearly related to locally detected atherosclerosis and known risk factors for atherosclerosis. Longitudinal studies are needed to clarify the role of arterial wall thickening in the atherosclerotic process.

Normative values of carotid artery intima-media thickness in healthy Korean adults and estimation of macrovascular diseases relative risk using this data in type 2 diabetes patients

“…The carotid artery IMT is known to have a positive correlation with various atherosclerotic risk factors, such as age, blood pressure, total cholesterol, and LDLcholesterol [16][17][18][19][20]. The correlation coefficients between IMT and age (r = 0.520 in healthy subjects; r = 0.429 in diabetic patients) were similar to previous studies [21][22][23].…”

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.…”

“…2 Several studies have shown that high SBP is a risk factor for carotid intima-media thickening. [3][4][5][6][7][8] Elevated PP has also been associated with carotid intima-media thickening. 3,6,8 Intima-media thickening has been suggested to represent an early phase of atherosclerosis preceding the development of plaques.…”

“…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.…”