Predictors of Carotid Intima-Media Thickness Progression in Young Adults: The Bogalusa Heart Study

Duke University, Durham, North Carolina, United States
Stroke (Impact Factor: 5.72). 04/2007; 38(3):900-5. DOI: 10.1161/01.STR.0000258003.31194.0a
Source: PubMed


We sought to evaluate the predictors of carotid intima-media thickness (CIMT) progression in young adults and to determine whether they differed between the sexes. Although risk factors for the progression of atherosclerosis in middle-aged and elderly adults are well known, they are less well understood in young adults. CIMT is a validated measure of subclinical atherosclerosis.
B-mode ultrasound images of the far walls of both carotid arteries were obtained in 336 young adults in the Bogalusa Heart Study, whose mean+/-SD age was 32.3+/-3.0 years. CIMT and risk factors were measured at baseline (1995-1996) and after 5.8+/-0.6 years. Multivariable regression was used to determine the predictors of CIMT progression.
CIMT progression rates in women (0.015+/-0.024 mm/y) and men (0.020+/-0.027 mm/y) were not statistically different after controlling for body mass index (P=0.155). Smoking was a statistically significant predictor of common and composite CIMT progression in both sexes. In men, systolic blood pressure was an independent predictor of internal carotid and composite CIMT progression, fasting glucose predicted common CIMT progression, and family history predicted composite CIMT progression.
In young adults, smoking was a consistent predictor of short-term CIMT progression in men and women. Traditional risk factors also predicted CIMT progression in men.

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Available from: Gerald S Berenson, Jan 17, 2015
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    • "Moreover, other proatherogenic factors, like total cholesterol, LDL-cholesterol and insulin resistance, have been shown to be significantly associated with cIMT.19,20 The Bougalusa Heart Study showed that the progression of cIMT was significantly associated with fasting blood glucose and systolic blood pressure in young adults.21 When the lifetime risk for cardiovascular disease was estimated using an algorithm including total cholesterol, blood pressure, smoking, and diabetes mellitus (DM), individuals with higher life time risk experienced a greater subclinical atherosclerosis burden.22 "
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    ABSTRACT: Primary prevention and early detection of cardiovascular disease is important, as it is the leading cause of death throughout world. Risk stratification algorithms, such as Framingham Risk Score and European Systematic Coronary Risk Evaluation, that utilize a combination of various traditional risk factors have been developed to improve primary prevention. However, the accuracy of these algorithms for screening high risk patients is moderate at best. Accordingly, the use of biomarkers or imaging studies may improve risk stratification. Carotid ultrasound, which measures both carotid intima-media thichkness (cIMT) and carotid plaque, is useful in detecting the degree of subclinical carotid atherosclerosis, and has the advantage of being noninvasive and safe. Several large epidemiologic studies have indicated that cIMT and carotid plaque are closely related with other cardiovascular risk factors and may be useful for risk reclassification in subjects deemed to be at intermediate risk by traditional risk scores. Moreover, recent clinical guidelines for management of hypertension or dyslipidemia highlight the usefulness of cIMT in high risk patients. In this article, we review evidence for the usefulness of measurement of cIMT and carotid plaque for cardiovascular risk stratification.
    Full-text · Article · May 2014 · Yonsei medical journal
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    • "A study on American children aged 10–14 years old who died from motorcycle accidents showed that 50% of them have early atherosclerosis evidence. Similarly, Bogalusa Heart Study revealed that 50% of its 204 subjects aged 2–15 years old had fatty streak in their coronary arteries [7]. An atherosclerosis which occurs in younger age "
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    ABSTRACT: Carotid intima media thickness (CIMT) is clearly associated with atherosclerosis. Studies in ischemic stroke patients reveal that there is a significant association between CIMT with monocyte chemoattractant protein-1 (MCP-1) and osteopontin (OPN) promoter polymorphism. This research aims to explain the effect of MCP-1 and OPN promoter polymorphism toward CIMT changes identified in Javanese Indonesian children. Subjects were 54 children: 27 were from parents with ischemic stroke (cases), and 27 were from healthy parents (controlled). The CIMT was examined by utilizing high resolution B-mode ultrasound. Physical examination and genotyping analysis of MCP-1 promoter were conducted by employing PCR method. Research results indicate that two polymorphisms were obtained, that is, A-2138T and G-2464A, respectively. A-2138T polymorphism was found in 5% of case children and in 14.3% of controlled children. G-2464A polymorphism was found in 5% of case children. CIMT of case children was significantly different from that of controlled children (0.61 ± 0.012 mm versus, 0.52 ± 0.015 mm, P = 0.021). Subjects with MCP-1 promoter polymorphism have 1.471 times higher tendency to have thicker CIMT than subjects with no polymorphism in MCP1 promoter. OPN promoter T-66G was also studied but it did not indicate occurrence of polymorphism in samples.
    Full-text · Article · Apr 2014 · Neurology Research International
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    • "The highest tertile of soy intake was associated with an 8.4% lower bifurcation cIMT than the lowest tertile (p for ANCOVA Z 0.047; p for trend Z 0.027) after adjustment for standard risk factors. It is known that the carotid bifurcation is more prone to atherosclerosis due to low sheer stress [45] and because of this greater cIMT progression is observed at this site [46]. In addition, bifurcation cIMT is associated with total and LDL cholesterol in women [47] which may explain the relationship seen between soy and bifurcation cIMT in this study. "
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    ABSTRACT: Aims To review: 1) the correlation between individual dietary components and carotid intima media thickness (cIMT); 2) the relationship between dietary patterns and cIMT; 3) the effect of dietary interventions on cIMT progression. Data synthesis An electronic search for epidemiological and intervention trials investigating the association between dietary components or patterns of intake and cIMT was performed in PUBMED, EMBASE and the Cochrane Library. Epidemiological data shows that a higher intake of fruit, wholegrains and soluble fibre and lower consumption of saturated fat in favour of polyunsaturated fat is associated with lower cIMT. In people at high risk of cardiovascular disease >93g/day of fruit is associated with lower cIMT. Lower cIMT has also been observed when > 0.79serves/day of wholegrains and >25g/day of fibre, predominately in the soluble form is consumed. Saturated fat is positively associated with cIMT, for every 10g/day increase in saturated fat cIMT is 0.03mm greater. Olive oil is inversely associated with cIMT, with a benefit seen when >34g/day is consumed. While there are many epidemiological studies exploring the association between dietary intake and cIMT there are few intervention studies. Intervention studies show that a Mediterranean diet may reduce cIMT progression, especially in those with a higher cIMT. Conclusions A Mediterranean style dietary pattern, which is high in fruits, wholegrains, fibre and olive oil and low in saturated fat, may reduce carotid atherosclerosis development and progression. However further research from randomised controlled trials is required to understand the association between diet and cIMT and the underlying mechanisms.
    Full-text · Article · Jan 2013 · Nutrition, metabolism, and cardiovascular diseases: NMCD
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