Association Between Carotid Artery Function and Structure in the Northern Manhattan Study

Area of Science:

• Vascular Biology
• Cardiovascular Research
• Atherosclerosis Imaging

Background:

• Carotid plaque (CP), carotid intima media thickness (cIMT), and arterial stiffness (STIFF) are pre-clinical markers of atherosclerosis.
• These markers predict cerebrovascular disease (CVD) risk.

Purpose of the Study:

• To investigate if STIFF is a significant determinant of cIMT and CP.
• To gain insight into the mechanism by which STIFF contributes to CVD risk.

Main Methods:

• Analysis of 876 stroke-free subjects from the Northern Manhattan Study with ultrasound measures.
• Multivariable-adjusted regression, negative binomial regression (for CP number), and multinomial logistic regression (for plaque area) were used to assess associations with STIFF.

Main Results:

• STIFF was positively associated with cIMT but not with CP.
• Diastolic diameter was associated with thick plaque, increasing risk by ~20% per mm increase.
• Longitudinal analysis showed a 37% increased risk of incident plaque per mm increase in diastolic diameter.

Conclusions:

• Increased STIFF is associated with increased cIMT and carotid artery dilatation with greater plaque burden.
• Increased cIMT and plaque burden represent vascular remodeling.
• These findings suggest distinct age-related mechanisms for diffuse wall thickening (cIMT with STIFF) and focal atherosclerosis (plaque with dilatation).