(Circulation. 1999;100:838-842.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Increased Carotid Intimal-Medial Thickness and Coronary Calcification Are Related in Young and Middle-Aged Adults
The Muscatine Study
Presented in part at the 70th Scientific Sessions of the American Heart Association, Orlando, Fla, November 11, 1997, and published in abstract form (Circulation. 1997;96[suppl I]:I-475).
From the Division of Cerebrovascular Diseases (P.H.D.), Department of Neurology, Division of Biostatistics (J.D.D., L.T.M., R.M.L.), Department of Preventive Medicine and Environmental Health, and Division of Pediatric Cardiology (L.T.M., R.M.L.), Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa.
Correspondence to Patricia H. Davis, MD, Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242. E-mail pdavis{at}uiowa.edu
Background—Increased carotid intimal-medial thickness (IMT) and coronary artery calcification (CAC) are used as 2 markers of early atherosclerosis. Our objectives were to assess whether increased IMT and CAC are related and to determine the relationship between cardiovascular risk factors and carotid IMT in young adults.
Methods and Results—A sample of 182 men and 136 women aged 33 to
42 years living in Muscatine, Iowa, underwent B-mode carotid ultrasound
to determine the mean of 12 measurements of maximal carotid IMT. CAC
was defined as calcification in the proximal coronary arteries
in 
3 contiguous pixels with a density of 130 HU. The mean IMT was
0.788 mm (SD 0.127) for men and 0.720 mm (SD 0.105) for
women. CAC was present in 27% of men and 14% of women and was
significantly associated with IMT in men (P<0.025) and
women (P<0.005). With multivariate
analysis, after adjustment for age, significant risk factors
for carotid IMT were LDL cholesterol
(P<0.001) and pack-years of smoking
(P<0.05) in men and LDL cholesterol
(P<0.001) and systolic blood pressure
(P<0.01) in women. These risk factors remained
significant after CAC was included in the multivariate
model.
Conclusions—There is an association between increased carotid IMT and CAC and between cardiovascular risk factors and increased IMT in young adults. Carotid IMT may provide information in addition to CAC that can be used to identify young adults with premature atherosclerosis.
Key Words: carotid arteries • ultrasonics • risk factors • arteriosclerosis • coronary disease
This article has been cited by other articles:
 |
|
 |
|
  D. Baldassarre, S. Castelnuovo, B. Frigerio, M. Amato, J. P. Werba, A. De Jong, A. L. Ravani, E. Tremoli, and C. R. Sirtori Effects of Timing and Extent of Smoking, Type of Cigarettes, and Concomitant Risk Factors on the Association Between Smoking and Subclinical Atherosclerosis Stroke, June 1, 2009; 40(6): 1991 - 1998. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. J. Lester, M. F. Eleid, B. K. Khandheria, and R. T. Hurst Carotid Intima-Media Thickness and Coronary Artery Calcium Score as Indications of Subclinical Atherosclerosis Mayo Clin. Proc., March 1, 2009; 84(3): 229 - 233. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. J. Kullo and A. R. Malik Arterial Ultrasonography and Tonometry as Adjuncts to Cardiovascular Risk Stratification J. Am. Coll. Cardiol., April 3, 2007; 49(13): 1413 - 1426. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. M. Johnson, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, S. Li, W. Chen, G. S. Berenson, and J. H. Stein Predictors of Carotid Intima-Media Thickness Progression in Young Adults: The Bogalusa Heart Study Stroke, March 1, 2007; 38(3): 900 - 905. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Cleary, T. J. Orchard, S. Genuth, N. D. Wong, R. Detrano, J.-Y. C. Backlund, B. Zinman, A. Jacobson, W. Sun, J. M. Lachin, et al. The Effect of Intensive Glycemic Treatment on Coronary Artery Calcification in Type 1 Diabetic Participants of the Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications (DCCT/EDIC) Study Diabetes, December 1, 2006; 55(12): 3556 - 3565. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 H. Watanabe, S. Soderlund, A. Soro-Paavonen, A. Hiukka, E. Leinonen, C. Alagona, R. Salonen, T.-P. Tuomainen, C. Ehnholm, M. Jauhiainen, et al. Decreased High-Density Lipoprotein (HDL) Particle Size, Pre{beta}-, and Large HDL Subspecies Concentration in Finnish Low-HDL Families: Relationship With Intima-Media Thickness Arterioscler Thromb Vasc Biol, April 1, 2006; 26(4): 897 - 902. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. S. Tzou, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, W. Chen, G. S. Berenson, and J. H. Stein Increased Subclinical Atherosclerosis in Young Adults With Metabolic Syndrome: The Bogalusa Heart Study J. Am. Coll. Cardiol., August 2, 2005; 46(3): 457 - 463. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Stein, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, S. Li, W. Chen, and G. S. Berenson Distribution and Cross-Sectional Age-Related Increases of Carotid Artery Intima-Media Thickness in Young Adults: The Bogalusa Heart Study Stroke, December 1, 2004; 35(12): 2782 - 2787. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. R. Folsom, G. W. Evans, J. J. Carr, A. E. Stillman, and Atherosclerosis Risk in Communities (ARIC) Study I Association of Traditional and Nontraditional Cardiovascular Risk Factors with Coronary Artery Calcification Angiology, November 1, 2004; 55(6): 613 - 623. [Abstract] [PDF]
|
|
|
|
 |
|
 A. H. Slyper What Vascular Ultrasound Testing Has Revealed about Pediatric Atherogenesis, and a Potential Clinical Role for Ultrasound in Pediatric Risk Assessment J. Clin. Endocrinol. Metab., July 1, 2004; 89(7): 3089 - 3095. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. B. J. Mancini, B. Dahlof, and J. Diez Surrogate Markers for Cardiovascular Disease: Structural Markers Circulation, June 29, 2004; 109(25_suppl_1): IV-22 - IV-30. [Full Text] [PDF]
|
|
|
|
|
|
S. Hallerstam, P. T. Larsson, E. Zuber, and S. Rosfors Carotid Atherosclerosis is Correlated with Extent and Severity of Coronary Artery Disease Evaluated by Myocardial Perfusion Scintigraphy Angiology, May 1, 2004; 55(3): 281 - 288. [Abstract] [PDF]
|
|
|
|
|
|
M. L. Bots, G. W. Evans, W. A. Riley, and D. E. Grobbee Carotid Intima-Media Thickness Measurements in Intervention Studies: Design Options, Progression Rates, and Sample Size Considerations: A Point of View Stroke, December 1, 2003; 34(12): 2985 - 2994. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Oren, L. E. Vos, C. S. P. M. Uiterwaal, D. E. Grobbee, and M. L. Bots Cardiovascular Risk Factors and Increased Carotid Intima-Media Thickness in Healthy Young Adults: The Atherosclerosis Risk in Young Adults (ARYA) Study Arch Intern Med, August 11, 2003; 163(15): 1787 - 1792. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. F. Redberg, R. A. Vogel, M. H. Criqui, D. M. Herrington, J. A. C. Lima, and M. J. Roman Task force #3--what is the spectrum of current and emerging techniques for the noninvasive measurement of atherosclerosis? J. Am. Coll. Cardiol., June 4, 2003; 41(11): 1886 - 1898. [Full Text] [PDF]
|
|
|
|
|
|
C. S. Fox, J. F. Polak, I. Chazaro, A. Cupples, P. A. Wolf, R. A. D'Agostino, and C. J. O'Donnell Genetic and Environmental Contributions to Atherosclerosis Phenotypes in Men and Women: Heritability of Carotid Intima-Media Thickness in the Framingham Heart Study Stroke, February 1, 2003; 34(2): 397 - 401. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. E. Bild, D. A. Bluemke, G. L. Burke, R. Detrano, A. V. Diez Roux, A. R. Folsom, P. Greenland, D. R. JacobsJr., R. Kronmal, K. Liu, et al. Multi-Ethnic Study of Atherosclerosis: Objectives and Design Am. J. Epidemiol., November 1, 2002; 156(9): 871 - 881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. B. Newman, B. L. Naydeck, K. Sutton-Tyrrell, D. Edmundowicz, D. O'Leary, R. Kronmal, G. L. Burke, and L. H. Kuller Relationship Between Coronary Artery Calcification and Other Measures of Subclinical Cardiovascular Disease in Older Adults Arterioscler Thromb Vasc Biol, October 1, 2002; 22(10): 1674 - 1679. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Adachi, Y. Hirai, Y. Fujiura, H. Matsuoka, A. Satoh, and T. Imaizumi Plasma Homocysteine Levels and Atherosclerosis in Japan: Epidemiological Study by Use of Carotid Ultrasonography Stroke, September 1, 2002; 33(9): 2177 - 2181. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. A. Lange, D. W. Bowden, C. D. Langefeld, L. E. Wagenknecht, J. J. Carr, S. S. Rich, W. A. Riley, and B. I. Freedman Heritability of Carotid Artery Intima-Medial Thickness in Type 2 Diabetes Stroke, July 1, 2002; 33(7): 1876 - 1881. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H.-H. S. Oei, R. Vliegenthart, A. E. Hak, A. I. del Sol, A. Hofman, M. Oudkerk, and J. C. M. Witteman The association between coronary calcification assessed by electron beam computed tomography and measures of extracoronary atherosclerosis: The rotterdam coronary calcification study J. Am. Coll. Cardiol., June 5, 2002; 39(11): 1745 - 1751. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. H. Davis, J. D. Dawson, W. A. Riley, and R. M. Lauer Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age: The Muscatine Study Circulation, December 4, 2001; 104(23): 2815 - 2819. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
P. Lundman, M. J. Eriksson, M. Stuhlinger, J. P. Cooke, A. Hamsten, and P. Tornvall Mild-to-moderate hypertriglyceridemia in young men is associated with endothelial dysfunction and increased plasma concentrations of asymmetric dimethylarginine J. Am. Coll. Cardiol., July 1, 2001; 38(1): 111 - 116. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. M. Colhoun, L. M. Scheek, M. B. Rubens, T. Van Gent, S. R. Underwood, J. H. Fuller, and A. Van Tol Lipid Transfer Protein Activities in Type 1 Diabetic Patients Without Renal Failure and Nondiabetic Control Subjects and Their Association With Coronary Artery Calcification Diabetes, March 1, 2001; 50(3): 652 - 659. [Abstract] [Full Text]
|
|