Carotid atherosclerosis, intima media thickness and risk factors—an analysis of 1781 asymptomatic subjects in Taiwan
Introduction
High resolution B-mode ultrasound is a noninvasive method for examining the walls of peripheral arteries and provides measures of the carotid artery intima media thickness (IMT) and of plaques that may indicate early presymptomatic disease. IMT has been proposed as a quantitative index of atherosclerosis and has been shown to be positively associated with coronary heart disease and stroke [1], [2], [3], [4]. In healthy adults, IMT ranges from 0.25 to 1.5 mm, and values >1.0 mm are often regarded as abnormal [5], [6], [7]. However, the ‘normal’ range and ‘abnormal’ value and even the risk factors associated with abnormal IMT might vary considerably between different populations [7], [8], [9], [10]. Ultrasonographic diagnosis of increased IMT in one individual at risk of atherosclerosis might help to stratify the risk factor, to better justify the decision to treat and to follow the efficacy of preventive therapy such as that involving the use of antihypertensive, antiplatelet, or lipid-lowering drugs [11], [12], [13].
Though the pathologic characteristics of atherosclerotic plaque and IMT are quite different, both are related to generalized atherosclerosis, and to cerebral and cardiac ischemic symptoms [14], [15]. IMT and carotid plaques can be used for predicting and evaluating progression/regression of atherosclerosis and for predicting subsequent clinical complications [16]. So, the screening and detection of the risk factors for carotid plaques and IMT are quite important before symptoms or disease really develop. And the correlations between IMT and carotid plaque need to be clarified [8], [9].
The first aim of present study was to define the mean and range of IMT in the carotid arteries of young to old subjects. The second aim was to investigate the correlation between IMT and carotid plaque and to define the cut value of IMT associated with significant prevalence of plaque. The third aim was to identify the risk factors associated with thick IMT and carotid plaque in asymptomatic subjects in Taiwan.
Section snippets
Subjects
This study was performed between April 1998 and February 2001. A total of 1961 subjects who consulted En Chu Kong Hospital for their general physical check-up underwent carotid duplex examination. All subjects resided in northern Taiwan and were asked information about smoking behavior, alcohol consumption, and previous disease. Those who had suffered from symptomatic vascular disease such as stroke, transient ischemia, coronary heart disease, congestive heart failure and intermittent
Results
A total of 1781 subjects, 1131 men and 650 women, was examined (mean age, 49 years; range 18–85 years).
Discussion
Though the increase of IMT with age was described in several previous reports, the progression rates were quite varied [7], [9], [10], [18]. Longitudinal estimates of progression rate of CCA IMT in our subjects was 0.005 mm year, which was much less than the rate of 0.06 mm per year in Finnish men [18] and less than 0.01 mm per year in participants from US communities [7], and 0.02 mm per year in another population study [5]. Such variation is likely to be due to the methodological differences.
References (23)
- et al.
Measurement of the ultrasonic intima-media complex thickness in normal subjects
J. Vasc. Surg.
(1993) - et al.
Distribution of ultrasonographically assessed dimensions of common carotid arteries in healthy adults of both sexes
Atherosclerosis
(2000) - et al.
Antiplatelet drugs attenuate progression of carotid intima-media thickness in subjects with type 2 diabetes
Thromb. Res.
(2000) - et al.
Progression of carotid atherosclerosis and its determinants: a population-based ultrasonography study
Atherosclerosis
(1990) - et al.
Carotid artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults
New Engl. J. Med.
(1999) - et al.
Carotid atherosclerosis, vascular risk profile and mortality in a population-based sample of functionally healthy elderly subjects: the Berlin ageing study
J. Int. Med.
(2000) - et al.
Common carotid artery intima-media thickness and brain infarction. GENIC case-control study
Circulation
(2000) - et al.
Carotid wall thickness is predictive of incident clinical stroke. The Atherosclerosis Risk in Communities (ARIC) study
Am. J. Epidemiol.
(2000) - et al.
Ultrasound B-mode imaging in observational studies of atherosclerotic progression
Circulation
(1993) - et al.
Carotid artery intimal–medial thickness distribution in general populations as evaluated by B-mode ultrasound
Stroke
(1993)
Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women. The British Regional Heart Study
Stroke
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