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Carotid Intima-Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional
Atinuke Akinmolayan1, A Olia Papacosta1, Lucy T Lennon1
1Department of Primary Care and Population Health University College London London United Kingdom.
Insights
Higher carotid intima-media thickness (CIMT) and lower carotid distensibility predict increased heart failure risk. These arterial changes are significant indicators for predicting incident heart failure (HF) in older men.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Background:
- Carotid intima-media thickness (CIMT) and carotid distensibility are established markers of arterial health.
- The association between these carotid measures and incident heart failure (HF) remains incompletely understood.
Purpose of the Study:
- To investigate the relationship between CIMT, carotid distensibility, and the risk of developing new-onset heart failure (HF).
Main Methods:
- Longitudinal analysis of 1631 men (aged 71-92) from the British Regional Heart Study without baseline HF.
- Carotid intima-media thickness (CIMT) and carotid distensibility were measured.
- Cox proportional hazards models assessed adjusted hazard ratios (HRs) for incident HF across CIMT and distensibility quartiles.
Main Results:
- Higher CIMT (top quartile) and lower carotid distensibility (bottom quartile) were significantly associated with increased risk of incident HF.
- Lower carotid distensibility showed a persistent association with incident HF even after adjusting for myocardial infarction and CIMT.
- Higher CIMT was associated with incident myocardial infarction, but its link to HF was attenuated after adjusting for MI and distensibility.
Conclusions:
- Elevated CIMT and reduced carotid distensibility are independent risk factors for incident heart failure (HF).
- These findings highlight the prognostic value of carotid artery assessment in predicting HF development.
Background:
Carotid intima-media thickness (CIMT) and carotid distensibility are markers of arterial change; however, little is known of the association with incident heart failure (HF). We aimed to assess this.
Methods:
This was a longitudinal analysis of data from the British Regional Heart Study, a prospective cohort study. A total of 1631 men aged 71 to 92 years, without a diagnosis of HF at baseline, were included. Between 2010 and 2012, participants completed a questionnaire, underwent a physical examination, and provided a fasting blood sample. CIMT and carotid artery distension were measured, and carotid distensibility was calculated. Cox proportional hazards modeling was used to assess the multivariate-adjusted hazard ratios (HRs) of incident HF by quartiles of CIMT and distensibility, excluding men with prevalent myocardial infarction.
Results:
The values used in the analysis were adjusted for age, social class, smoking, physical activity, alcohol status, body mass index, use of statins and antihypertensives, prevalent diabetes and stroke, pulse pressure, and presence of atrial arrhythmias. Lower carotid distensibility (bottom quartile) and higher CIMT (top quartile) were associated with increased risk of incident HF (HR, 2.55 [95% CI, 1.24-5.24]; P=0.01; and HR, 2.20 [95% CI, 1.14-4.23]; P=0.02, respectively). CIMT but not carotid distensibility was associated with incident myocardial infarction. The association between carotid distensibility and incident HF persisted after adjustment for incident myocardial infarction and CIMT (HR, 2.53 [95% CI, 1.23-5.22]; P=0.01); however, the association between CIMT and incident HF was attenuated after this adjustment (HR, 1.64 [95% CI, 0.84-3.21]; P=0.15).
Conclusions:
Lower carotid distensibility and higher CIMT were associated with an increased risk of incident HF, despite adjustment for incident myocardial infarction.
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