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Carotid intima-media thickness and coronary heart disease risk factors in a low-risk population
J Ferrières1, A Elias, J B Ruidavets
1Department of Epidemiology (INSERM U 518), Purpan Hospital, Toulouse, France.
Insights
In a low-risk population, carotid intima-media thickness (IMT) was associated with traditional coronary heart disease (CHD) risk factors. Protective factors like HDL cholesterol and moderate alcohol intake may be key in preventing early atherosclerosis.
Area of Science:
- Cardiovascular epidemiology
- Vascular biology
- Public health
Background:
- Coronary heart disease (CHD) risk factors are linked to increased carotid intima-media thickness (IMT) in some populations.
- Few population-based studies have investigated CHD risk factors' influence on IMT in low-risk groups.
Purpose of the Study:
- To examine the association between carotid IMT and CHD risk factors in a representative sample of middle-aged men and women from a low-CHD risk European population.
Main Methods:
- Utilized high-resolution B-mode ultrasonography to assess carotid IMT in 1013 individuals.
- Analyzed associations between IMT and various CHD risk factors, including age, BMI, blood pressure, lipids, and lifestyle factors.
Main Results:
- Multiple factors including age, smoking, BMI, blood pressure, and cholesterol levels were associated with IMT.
- In men, independent associations were found with age, smoking, SBP, HDL cholesterol, and alcohol intake.
- In women, only age and SBP were independently associated with IMT.
Conclusions:
- Carotid IMT in this low-risk population was thinner than in high-risk groups, suggesting it reflects localized atherosclerosis.
- Protective factors like HDL cholesterol and moderate alcohol consumption appear crucial in mitigating early atherosclerotic changes.
Objective:
Coronary heart disease (CHD) risk factors have been consistently related to an increase in carotid intima-media thickness (IMT) in selected populations. However, few studies were population-based and furthermore little attention has been given to the influence of CHD risk factors on IMT in low-risk populations for CHD.
Design:
We examined the association between carotid IMT and CHD risk factors in a large (n = 1013) and representative sample of middle-aged men and women in one of the European populations with the lowest CHD risk.
Methods:
High-resolution B-mode ultrasonography of the common carotid arteries was performed.
Results:
Age, smoking (not significant in women), body mass index, waist to hip ratio, systolic (SBP) and diastolic blood pressure, alcohol consumption, total and low-density lipoprotein cholesterol, triglycerides, glycaemia, fibrinogen (not significant in women), haematocrit (not significant in men) and insulin (not significant in women) were positively and significantly associated with mean IMT. High-density lipoprotein (HDL) cholesterol (not significant in women) was negatively and significantly associated with mean IMT. In a subsample of 355 men, IMT was not associated with angiotensin I-converting enzyme gene polymorphism. Multivariate analyses showed, in men, independent associations between mean IMT (0.61+/-0.11 mm) and age, pack-years, SBP, HDL cholesterol, alcohol and the interaction between age and alcohol. In women, only age and SBP were independently associated with mean IMT (0.58+/-0.09 mm).
Conclusions:
We found thinner IMT than those found in high-risk populations, suggesting that an increased IMT might reflect local atherosclerosis. Protective factors such as HDL cholesterol or regular and moderate alcohol consumption are probably important determinants of the early stages of atherosclerosis in these low-risk populations.