Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Nov;45(11):3257-62.
doi: 10.1161/STROKEAHA.114.005669. Epub 2014 Sep 11.

Predictors of carotid thickness and plaque progression during a decade: the Multi-Ethnic Study of Atherosclerosis

Matthew C Tattersall  1 , Amanda Gassett  1 , Claudia E Korcarz  1 , Adam D Gepner  1 , Joel D Kaufman  1 , Kiang J Liu  1 , Brad C Astor  1 , Lianne Sheppard  1 , Richard A Kronmal  1 , James H Stein  2
Affiliations

Predictors of carotid thickness and plaque progression during a decade: the Multi-Ethnic Study of Atherosclerosis

Matthew C Tattersall et al. Stroke. 2014 Nov.

Abstract

Background and purpose: Carotid artery intima-media thickness (IMT) and plaque are noninvasive markers of subclinical arterial injury that predict incident cardiovascular disease. We evaluated predictors of longitudinal changes in IMT and new plaque during a decade in a longitudinal multiethnic cohort.

Methods: Carotid IMT and plaque were evaluated in Multi-Ethnic Study of Atherosclerosis (MESA) participants at exams 1 and 5, a mean (standard deviation) of 9.4 (0.5) years later. Far wall carotid IMT was measured in both common and internal carotid arteries. A plaque score was calculated from all carotid segments. Mixed-effects longitudinal and multivariate regression models evaluated associations of baseline risk factors and time-updated medication use with IMT progression and plaque formation.

Results: The 3441 MESA participants were aged 60.3 (9.4) years (53% women; 26% blacks, 22% Hispanic, 13% Chinese); 1620 (47%) had carotid plaque. Mean common carotid artery IMT progression was 11.8 (12.8) μm/year, and 1923 (56%) subjects developed new plaque. IMT progressed more slowly in Chinese (β=-2.89; P=0.001) and Hispanic participants (β=-1.81; P=0.02), and with higher baseline high-density lipoprotein cholesterol (per 5 mg/dL; β=-0.22; P=0.03), antihypertensive use (β=-2.06; P=0.0004), and time on antihypertensive medications (years; β=-0.29; P<0.0001). Traditional risk factors were associated with new plaque formation, with strong associations for cigarette use (odds ratio, 2.31; P<0.0001) and protection by black ethnicity (odds ratio, 0.68; P<0.0001).

Conclusions: In a large, multiethnic cohort with a decade of follow-up, ethnicity was a strong, independent predictor of carotid IMT and plaque progression. Antihypertensive medication use was associated with less subclinical disease progression.

Keywords: atherosclerosis; carotid arteries; epidemiology; risk factors.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Adjusted Carotid Intima-Media Thickness Progression by Ethnicity ± Adjusted IMT progression rate differs compared to Caucasian ethnicity (p<0.05) Models adjusted for: age, sex body-mass index, systolic blood pressure, tobacco use, total cholesterol, high-density lipoprotein, glucose, income, education, family history, diabetes mellitus, antihypertensive medication use, statin medication use Error bars represent estimated means +/− standard error of the mean
See this image and copyright information in PMC

References

    1. Stein JH, Korcarz CE, Hurst RT, Lonn E, Kendall CB, Mohler ER, et al. Use of carotid ultrasound to identify subclinical vascular disease and evaluate cardiovascular disease risk: A consensus statement from the american society of echocardiography carotid intima-media thickness task force. Endorsed by the society for vascular medicine. J Am Soc Echocardiogr. 2008;21:93–111. quiz 189–190. - PubMed
    1. Lorenz MW, Markus HS, Bots ML, Rosvall M, Sitzer M. Prediction of clinical cardiovascular events with carotid intima-media thickness: A systematic review and meta-analysis. Circulation. 2007;115:459–467. - PubMed
    1. Den Ruijter HM, Peters SA, Anderson TJ, Britton AR, Dekker JM, Eijkemans MJ, et al. Common carotid intima-media thickness measurements in cardiovascular risk prediction: A meta-analysis. Jama. 2012;308:796–803. - PubMed
    1. Espeland MA, O’Leary DH, Terry JG, Morgan T, Evans G, Mudra H. Carotid intimal-media thickness as a surrogate for cardiovascular disease events in trials of hmg-coa reductase inhibitors. Curr Control Trials Cardiovasc Med. 2005;6:3. - PMC - PubMed
    1. Herder M, Johnsen SH, Arntzen KA, Mathiesen EB. Risk factors for progression of carotid intima-media thickness and total plaque area: A 13-year follow-up study: The Tromsø study. Stroke. 2012;43:1818–1823. - PubMed

Publication types