Gender divergence on the impact of multiple cardiovascular risk factors on the femoral artery intima-media thickness in asymptomatic young adults: the Bogalusa Heart Study

Abstract

Introduction: Gender divergence on the impact of multiple cardiovascular risk factors on the femoral artery intima-media thickness (IMT) has not been studied in a biracial (black-white) community-based asymptomatic young adults.

Methods: Femoral IMT was measured by B-mode ultrasonography in 1080 individuals (age, 24-43 years; 71% white; 43% men) enrolled in the Bogalusa Heart Study.

Results: Femoral IMT showed a gender difference (men > women; P = 0.001), but no racial difference. In a multivariate model, age, cigarette smoking, systolic blood pressure and total cholesterol to high-density lipoprotein cholesterol ratio related independently, in that order, to IMT in women, and age and low-density lipoprotein cholesterol in men. In women, mean IMT increased with increasing number of risk factors defined as values above the age-, race- and gender-specific 75th percentile of systolic blood pressure, waist circumference, total cholesterol to high-density lipoprotein cholesterol ratio and insulin along with positive smoking status (P for trend = 0.001), with respective mean IMT (mm) values of 0.61, 0.65, 0.72 and 0.77, for 0, 1 to 2, 3 and 4 to 5 risk factors. There was no such significant trend in men.

Conclusions: Although men versus women had thicker IMT, the observed increasing trend of femoral IMT with increasing number of risk factors in asymptomatic young women suggests that women may be relatively more susceptible to the burden of multiple risk factors.

Figure 1

The effect of multiple risk factors on intima-media thickness (IMT) of femoral artery in males and females. A highly significant trend of increasing thickness is shown with greater number of risk factors in females. No such trend of increasing thickness is shown in males. Risk factors included were total cholesterol to HDL cholesterol ratio, waist circumference, systolic blood pressure, insulin level (>75^th percentile specific for age, race, gender) and smoking. HDL, high density lipoprotein. Bar represents standard error of mean.