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Risk factors for progression of common carotid atherosclerosis: the Atherosclerosis Risk in Communities Study,

Lloyd E Chambless1, Aaron R Folsom, Vicki Davis

  • 1Department of Biostatistics, School of Public Health, University of North Carolina, Chapel Hill, NC 27514-4145, USA. wchambless@unc.edu

American Journal of Epidemiology
|January 5, 2002
PubMed

Insights

Established coronary heart disease risk factors, such as diabetes and smoking, are linked to the progression of subclinical atherosclerosis, measured by intima-media thickness changes.

Area of Science:

  • Cardiovascular Disease Epidemiology
  • Atherosclerosis Research
  • Public Health

Background:

  • Intima-media thickness (IMT) of common carotid arteries serves as a key biomarker for atherosclerosis.
  • IMT is significantly associated with prevalent and incident coronary heart disease (CHD) and its risk factors.

Purpose of the Study:

  • To investigate the association between baseline and changing cardiovascular risk factors and the progression of subclinical atherosclerosis.
  • To analyze changes in intima-media thickness (IMT) in relation to established CHD risk factors over time.

Main Methods:

  • Utilized data from the Atherosclerosis Risk in Communities (ARIC) study, a population-based cohort (n=15,792, ages 45-64 at baseline).
  • Assessed changes in IMT from 1987-1998 in relation to baseline and changing risk factors, with and without adjustment for baseline IMT and measurement error.
  • Examined associations with baseline risk factors (diabetes, smoking, HDL cholesterol, pulse pressure, WBC count, fibrinogen) and changes in risk factors (LDL cholesterol, triglycerides, onset of diabetes, hypertension).

Main Results:

  • Statistically significant associations were observed between changes in IMT and baseline diabetes, current smoking, high-density lipoprotein cholesterol, pulse pressure, white blood cell count, and fibrinogen.
  • Significant associations were also found between changes in IMT and changes in low-density lipoprotein cholesterol, triglycerides, and the onset of diabetes and hypertension.
  • The magnitude of these associations aligned with previous cross-sectional findings.

Conclusions:

  • Established coronary heart disease risk factors are demonstrably associated with the rate of progression of subclinical atherosclerosis.
  • Changes in IMT reflect the impact of both existing and developing risk factors over time.
  • This study reinforces the importance of managing cardiovascular risk factors to mitigate atherosclerosis progression.

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