Abstract 13308: Prevalent Cardiovascular Disease and Progression of Carotid Intima-Media Thickness
Background: Common carotid artery (CCA) intima-media thickness (IMT) is a measure of atherosclerosis. Atherosclerosis progression may depend on the presence of cardiovascular disease (CVD). We evaluate associations of IMT progression with cardiovascular risk factors and prevalent CVD.
Methods: Risk factors of the Framingham Risk Score (FRS) were obtained at a baseline visit (1995-1998) and mean CCA IMT was measured at two visits: 1995-1998 and 2004-2007 in 2339 members of the Framingham offspring cohort. Linear regression models were used to evaluate the associations between IMT rate-of-change (mm/year), Framingham risk factors, prevalent CVD (absent, developing during follow-up, or present throughout follow-up), lipid-lowering, and blood pressure lowering therapies. Backward stepwise multivariable linear regression models were generated for IMT rate-of-change as outcome.
Findings: Average age was 57.1 years with 46% males. Over 9.4 years, IMT rate-of-change was 0.009 mm/year (+/− 0.010 mm/year std dev). Age, male gender, increased systolic pressure, smoking, hypertension treatment, HDL cholesterol, and prevalent CVD were strongly associated with IMT rate-of-change. Multivariable models adjusted for age, gender, smoking, lipid-lowering therapy, systolic, and diastolic pressure showed that individuals with CVD had a higher mean IMT progression rate of 0.011mm/year (95% Confidence Intervals: 0.0099, 0.0130) as compared to 0.0085 mm/year (95% Confidence Intervals; 0.0081, 0.0089) in individuals without CVD at both visits.
Conclusion: IMT progression is higher in individuals with prevalent cardiovascular disease than those without. Preventing the transition to clinical CVD may have stronger health care implications than previously thought.
- © 2011 by American Heart Association, Inc.