Abstract 3630: Subclinical Aortic Atherosclerosis in Men and Women in the Community Free of Cardiovascular Disease and Hypertension
INTRODUCTION: Cardiovascular magnetic resonance (CMR) is a gold standard test for in vivo detection of subclinical aortic plaque, but data are limited regarding the distribution of aortic plaque in healthy adults. We determined aortic plaque prevalence by CMR in persons from a longitudinally-followed cohort free of cardiovascular disease (CVD) and hypertension (HTN).
METHODS: A total of 1763 adults from the Framingham Heart Study Offspring cohort, followed since 1974, underwent CMR (Philips, 1.5T). Data from 786 (305 men, 481 women) without history of CVD and HTN (no SBP>140 or DBP>90 mmHg at any cycle examination, no use of antihypertensives) were analyzed. Subjects (aged 65±9 years, range 37– 89 years) underwent ECG-gated T2W black-blood CMR. The descending aorta was imaged with 36 transverse, 5-mm thick slices. A blinded expert reviewer manually analyzed the cross-sectional area of each plaque by planimetry. Overall plaque prevalence, slice plaque burden (% of slices with plaque), and area plaque burden (total plaque area/total aortic cross-sectional area) were determined by sex and by quartile age.
RESULTS: Overall aortic plaque prevalence was greater in women (46%) than in men (36%, p<0.006, Table⇓); prevalence increased with quartile age for both genders (p<0.02 for trend, Table⇓). For those free of CVD and HTN, women had greater slice plaque (4.9% vs. 2.8%) and area plaque burden (0.8% vs. 0.4%) than men. Aortic plaque was more common in the abdomen than the thorax (M 18:1, W 11:1). However, in a less restrictive sample of subjects free of CVD but including hypertensives (n=1562), there was no significant sex difference in plaque prevalence (48%W, 44%M, P=0.09).
CONCLUSION: Subclinical aortic atherosclerosis is found in over one-third of healthy subjects free of clinical CVD and HTN. Sex differences in plaque prevalence were seen only among subjects without prior HTN. These data emphasize the importance of focusing on women as well as men in primary prevention of CVD.