Abstract 13376: Lipid-Lowering Therapy Decreases Common Carotid Artery Intima-Media Thickness (IMT) Progression in Individuals Free of Prevalent Cardiovascular Disease: The Framingham Heart Study
Background: Common carotid artery (CCA) intima-media thickness (IMT) is a surrogate measure of atherosclerosis. Pharmacologic intervention decreases IMT progression in intervention trials but these results have not been replicated in the general population. We evaluate associations of IMT progression with cardiovascular risk factors, lipid and blood pressure lowering therapies. Materials and
Methods: Longitudinal follow-up of 2141 members of the Framingham offspring cohort. Framingham Risk Score (FRS) variables, history of blood pressure and lipid lowering therapy were obtained at baseline visit (1995-1998) while mean CCA IMT was measured at two visits: 1995-1998 and 2004-2007. IMT rate-of-change (mm/year) served as outcome for linear regression models and multivariable linear regression (backward selection) with risk factors, blood pressure and lipid-lowering therapies as independent variables.
Results: Average age was 56.6 years with 45.5% males. IMT increased at an annual rate-of-change of 0.0085 mm/year (+/− 0.0087 mm/year std dev) during a mean follow-up of 9.5 years. Final multivariable models showed that lipid-lowering treatment was associated with lower IMT progression rates (0.0071 mm/year; 95% C.I. 0.0062, 0.0087 v 0.0086 mm/year; 95%C.I. 0.0082, 0.0090) after adjustment for age, male gender, HDL-cholesterol, smoking, systolic and diastolic pressure.
Conclusion: Progression of IMT in this longitudinally followed community based cohort is principally associated with smoking, higher blood pressure and lower HDL-cholesterol. Lipid-lowering treatment is associated with significantly lower IMT progression rates confirming that primary prevention can decrease the progression of atherosclerosis in asymptomatic individuals.
- © 2011 by American Heart Association, Inc.