Abstract MP54: Extent of Subclinical Atherosclerosis and Associations with Cardiovascular Disease Risk Factors Vary by Race/Ethnicity in Late Midlife Women: The Study of Women’s Health Across the Nation
Subclinical atherosclerosis indices, such as carotid intima-media thickness (IMT) and plaque, have been linked to future CHD, MI and stroke events, are more prevalent in postmenopausal women and vary by race/ethnicity. In most studies, African American (AA) women have greater IMT (mainly in the common carotid artery; CCA) and larger carotid adventitial diameter (AD; a measure of vascular adaption). These differences may reflect the higher levels of CVD risk in AA women. However, population-based studies have reported lower carotid plaque and coronary calcification in AA women compared to Caucasian women. Less is known about late midlife women of other racial/ethnic groups including Hispanic and Chinese women. We evaluated whether racial/ethnic differences exist in CCA-IMT, AD and presence of carotid plaque, and in their associations with CVD risk factors in late midlife women.
Methods: Participants (85% postmenopausal; mean±SD age 60±3 years) from the Study of Women’s Health Across the Nation, who were free of CVD and had CCA-IMT, AD or plaque presence assessed at the 12th annual visit, were included in these analyses. Multivariable linear or logistic regression was used as appropriate. Models were adjusted for CVD risk factors (Table).
Results: Compared to Caucasian women, CCA-IMT was greater in AA women, AD greater in AA and Chinese women and plaque prevalence was lower in AA and Hispanic women (Table). Independent correlates of CCA-IMT were age and SBP in all groups and BMI and glucose in Caucasian and Chinese women only. Correlates of AD were SBP, BMI and height in Caucasian, AA and Chinese women, insulin and antihypertensive medications in AA and glucose in Caucasian women. Smoking and lower education were independently associated with plaque in AA women (age, smoking and glucose in Caucasian women).
Conclusion: The extent of subclinical atherosclerosis and associations with CVD risk factors vary by race/ethnicity, indicating that vascular adaptation to risk factors may differ across racial/ethnic groups in midlife women.
- © 2013 by American Heart Association, Inc.