Segment-Specific Associations of Carotid Intima-Media Thickness With Cardiovascular Risk Factors

Abstract

Background and Purpose-We propose to study possible differences in the associations between risk factors for cardiovascular disease (myocardial infarction and stroke) and carotid intima-media thickness (IMT) measurements made at 3 different levels of the carotid bifurcation. Methods-We conducted a cross-sectional study of a cohort of whites and blacks of both genders with a mean age of 45 years. Traditional cardiovascular risk factors were determined in cohort members. Carotid IMT was measured from high-resolution B-mode ultrasound images at 3 levels: the common carotid artery, the carotid artery bulb (bulb), and the internal carotid artery. Associations with risk factors were evaluated by multivariate linear regression analyses. Results-Of 3258 who underwent carotid IMT measurements, common carotid artery, bulb, and internal carotid artery IMT were measured at all 3 separate levels in 3023 (92.7%). A large proportion of the variability of common carotid artery IMT was explained by cardiovascular risk factors (26.8%) but less so for the bulb (11.2%) and internal carotid artery (8.0%). Carotid IMT was consistently associated with age, low-density lipoprotein cholesterol, smoking, and hypertension in all segments. Associations with fasting glucose and diastolic blood pressure were stronger for common carotid artery than for the other segments. Hypertension, diabetes, and current smoking had qualitatively stronger associations with bulb IMT and low-density lipoprotein cholesterol with internal carotid artery IMT. Conclusion-In our cohort of relatively young white and black men and women, a greater proportion of the variability in common carotid IMT can be explained by traditional cardiovascular risk factors than for the carotid artery bulb and internal carotid arteries. (Stroke. 2010;41:9-15.)

Prospective Association of Polycystic Ovary Syndrome With Coronary Artery Calcification and Carotid-Intima-Media Thickness

“…In an earlier report from the CARDIA study that used data from both men and women, cardiovascular risk factors explained a larger proportion of the CCA-IMT variability (26.8%) than the bulb (11.2%) or ICA (8.0%). 32 Furthermore, in The Vascular Aging (EVA) study, systolic blood pressure and hypertension were associated with both CCA-IMT and plaques at the Bulb and ICA; however, diabetes mellitus, lowdensity lipoprotein cholesterol, and high-density lipoprotein cholesterol were associated only with CCA-IMT. 33 Similarly, among Taiwanese women, the metabolic syndrome was only associated with CCA-IMT, but not with the bulbar or ICA-IMT.…”

“…Free and total testosterone measures were assessed using stored samples from CARDIA Year 2 (ages [20][21][22][23][24][25][26][27][28][29][30][31][32][33][34] by the OB/GYN Research and Diagnostic Laboratory at the University of Alabama, Birmingham. Total testosterone was measured using a competitive immunoassay (Beckman Coulter, Fullerton, CA) using direct chemiluminescent technology on the Beckman Access Automated System.…”

Insulin Sensitivity and Carotid Intima-Media Thickness

“…men and women and further controlled for conventional cardiovascular risk factors and habitual physical activity (PA). 16 Carotid IMT was measured at the level of common carotid artery (CCA) because previous studies have demonstrated that traditional risk factors 17 and metabolic variables 18 account for a greater proportion of IMT variability in the CCA than in the carotid bulb or internal carotid artery, and that the reproducibility of measurements is better for CCA than for other carotid segments. 19 The presence of plaques, however, was evaluated in the entire extracranial carotid tree as one of the first and the most common site of early atherosclerotic plaque formation is carotid bifurcation.…”

Non-alcoholic fatty liver disease, bulb carotid intima-media thickness and obesity phenotypes: results of a prospective observational study

“…Polak et al [17] showed that FPG and diastolic BP had a stronger association with CIMTc while hypertension, diabetes, and smoking with CIMTb.…”

“…Evaluation of CIMT includes evaluation of common carotid artery (CIMTc), bifurcation (bulb; CIMTb), and internal carotid artery and it has been shown that the association of the CIMT with CV risk factors varies according to the segment assessed [17]. The association between CIMT and NAFLD has been reported in the past years and this association was independent of other CV risk factors [18,19].…”