Risk Factors for Popliteal and Carotid Wall Thicknesses In the Atherosclerosis Risk in Communities (ARIC) Study

Abstract

The authors evaluated risk factors potentially associated with the development of popliteal artery atherosclerosis in a population-based study and compared them with factors linked to carotid wall intimal-medial thickness. The Atherosclerosis Risk in Communities (ARIC) Study is a longitudinal investigation of cardiovascular disease in 15,800 individuals. The present analyses are based on the baseline popliteal and carotid ultrasonography examination in 10,002 subjects conducted in 1987-1989. After adjustment for covariates, both carotid and popliteal intimal-medial thicknesses were strongly associated with male sex and age (p < 0.01), having a graded relation with increasing quartiles of plasma total cholesterol and low density lipoprotein cholesterol and with plasma triglycerides (women only for popliteal) (p < 0.01). An inverse correlation was noted between plasma high density lipoprotein cholesterol and carotid (p < 0.01) and popliteal (women only) (p < 0.05) intimal-medial thicknesses. Cigarette use (p < 0.01), a history of diabetes mellitus (p < 0.01), alcohol use, elevated systolic pressures (p < 0.01), and fibrinogen levels (p < 0.01) were directly associated with both popliteal and carotid intimal-medial thicknesses. Although menopause was associated with thickened carotid (p < 0.01) and popliteal (p < 0.05) intimal-medial thicknesses, hormone replacement therapy was associated with thinner carotid walls only (p < 0.05). Although there were some differences, many of the classical risk factors associated with cardiovascular disease were also related to early thickening of both the popliteal and the carotid artery walls.

Evidence for Association Between Polycystic Ovary Syndrome and Premature Carotid Atherosclerosis in Middle-Aged Women

“…Weight and BMI, as well as waist circumference, have been associated with increased subclinical atherosclerosis in several recent studies. 21,22,32,33 In the present study as well, BMI was a powerful predictor of IMT, particularly in women with PCOS. In the stratified analysis, IMT was greater in thin and heavy women with PCOS compared with controls of similar size.…”

Cholesteryl ester transfer protein genetic polymorphisms, HDL cholesterol, and subclinical cardiovascular disease in the Multi-Ethnic Study of Atherosclerosis

“…In the current study, we confirmed that HDL-C concentrations are inversely associated with carotid IMT [30,31]. Despite these findings, and the fact that the five CETP polymorphisms investigated were associated with differences in HDL-C concentrations, variants in the CETP gene were not associated with either common or internal carotid IMT.…”

2011 ASA/ACCF/AHA/AANN/AANS/ACR/ASNR/CNS/SAIP/SCAI/SIR/SNIS/SVM/SVS Guideline on the Management of Patients With Extracranial Carotid and Vertebral Artery Disease

“…24 In the Insulin Resistance Atherosclerosis Study, diabetes and fasting glucose levels were associated with carotid IMT, and carotid IMT progressed twice as rapidly in patients with diabetes as in those without diabetes. [293][294][295] Similarly, in the ARIC study, diabetes was associated with progression of carotid IMT, 254,291,296 and in the Rotterdam study, diabetes predicted progression to severe carotid obstruction. 297 In the EDIC (Epidemiology of Diabetes Interventions and Complications) study, the progression of carotid IMT was greater in patients with diabetes than in those without diabetes 298 and less in patients with diabetes treated with intensive insulin therapy than in those managed more conventionally.…”