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Cardiovascular risk factors for early carotid atherosclerosis in the general population: the Edinburgh Artery Study
P I Mowbray1, A J Lee, G R Fowkes
1Department of Public Health Sciences, Medical School, Edinburgh, UK.
Insights
Cardiovascular risk factors for early carotid atherosclerosis differ between men and women. Smoking and HDL cholesterol impact men, while alcohol, blood pressure, and HDL cholesterol affect women, highlighting the need for sex-specific research.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Background:
- Identifying cardiovascular risk factors for early carotid atherosclerosis remains challenging.
- Previous studies on intima-media thickness (IMT) have yielded inconclusive results.
- Carotid atherosclerosis is a key indicator of cardiovascular disease risk.
Purpose of the Study:
- To investigate the association between traditional cardiovascular risk factors and IMT.
- To explore potential sex differences in these associations.
Main Methods:
- Utilized data from the Edinburgh Artery Study, including 1106 participants aged 60-80 years.
- Assessed common carotid artery intima-media thickness (IMT) via ultrasound.
- Collected data on cardiovascular risk factors at baseline and during a 5-year follow-up.
Main Results:
- For men, lifetime smoking (pack years) and HDL:total cholesterol ratio were associated with IMT in multivariate analysis.
- For women, alcohol consumption, systolic blood pressure, and HDL:total cholesterol ratio were associated with IMT.
- Age was also a significant factor for men in univariate analysis.
Conclusions:
- Cardiovascular risk factors influencing IMT show distinct patterns between men and women.
- Further sex-specific research in prospective studies is crucial for understanding early carotid atherosclerosis.
- These findings underscore the importance of personalized risk assessment for cardiovascular disease.
Background:
Recent attempts to identify cardiovascular risk factors affecting early-stage carotid atherosclerosis, measured by ultrasonographically assessed intima-media thickness, have been inconclusive.
Objective:
To study the relationship between traditional cardiovascular risk factors and intima-media thickness.
Methods:
Ultrasonic evaluation of the intima-media thickness of the common carotid artery was included in the 5-year follow-up examination of participants of the Edinburgh Artery Study. We had valid readings of intima-media thickness for 1106 men and women aged 60-80 years. Information on a range of cardiovascular risk factors had been collected during the baseline examination.
Results:
For men, in addition to age, lifetime smoking (measured in terms of pack years) was the only cardiovascular risk factor associated with increased intima-media thickness (P< or = 0.01) in the univariate analysis. Both systolic blood pressure (P < or = 0.001) and the high-density lipoprotein (HDL: total cholesterol ratio (P < or = 0.01) were correlated with intima-media thickness for women. When all the variables had been included in a multivariate analysis, pack years of smoking and the HDL:total cholesterol ratio were associated with early atherosclerotic development in men. In an equivalent analysis for women, alcohol consumption, systolic blood pressure and the HDL:total cholesterol ratio were associated with intima-media thickness.
Conclusion:
These data suggest that risk factors affecting intima-media thickness differ for men and women. Further sex-specific analyses of prospective population studies are required in order to clarify the role of 'traditional' cardiovascular risk factors in the early stages of carotid atherosclerosis.