© 2000 American Heart Association, Inc.
Atherosclerosis and Lipoproteins |
Blood Pressure, LDL Cholesterol, and Intima-Media Thickness
A Test of the "Response to Injury" Hypothesis of Atherosclerosis
From the Department of Preventive Medicine, Institute for Prevention Research, Keck School of Medicine of the University of Southern California, Los Angeles, and the Division of Cardiology (C.N.B.M.), Department of Medicine, Cedars-Sinai Research Institute, Cedars-Sinai Medical Center and Department of Medicine, University of California at Los Angeles School of Medicine.
Abstract—The "response to injury" hypothesis is a plausible model of the development of atherosclerosis supported by observations from animal models. The present study uses epidemiological data to investigate the hypothesis that wall damage due to hypertension is a precursor of low density lipoprotein cholesterol (LDL-C)–mediated atherosclerosis. The Los Angeles Atherosclerosis Study is following a cohort of 576 participants who were aged 40 to 60 years and were free of symptomatic cardiovascular disease at recruitment. Common carotid artery intima-media thickness (IMT) was assessed by B-mode ultrasonography. After exclusion for nonfasting blood draw and other missing data, 511 subjects were available for analysis. IMT was regressed on LDL-C within tertiles of systolic blood pressure (SBP): low (93 to 122 mm Hg), middle (123 to 132 mm Hg), and high (133 to 175 mm Hg). Covariates were age, sex, body height, body mass index, ethnicity, smoking status, diabetes, and pharmacological treatment for hypertension or hypercholesterolemia. IMT was significantly related to LDL-C in the high SBP group (ß=0.025±0.008, where ß values are IMT [mm]/LDL-C [mmol/L]; P=0.002) but not in the middle (ß=-0.006±0.008, P=0.39) or low (ß=-0.004±0.009, P=0.64) SBP group. The slope in the high SBP group was significantly greater than in the middle (P=0.004) or low (P=0.014) SBP group. Results were similar for women and men, and after the exclusion of diabetics and persons using antihypertensive or lipid-lowering medications. Elevated LDL-C was associated with increased IMT in the upper tertile of SBP but not in the lower tertiles. These findings are consistent with the hypothesis that wall injury due to elevated SBP increases the susceptibility of the artery wall to LDL-C–mediated atherogenesis.
Key Words: atherosclerosis • response-to-injury model • intima-media thickness • LDL cholesterol • blood pressure
This article has been cited by other articles:
 |
|
 |
|
  D. Versari, M. Gossl, D. Mannheim, E. Daghini, O. Galili, C. Napoli, L. O. Lerman, and A. Lerman Hypertension and Hypercholesterolemia Differentially Affect the Function and Structure of Pig Carotid Artery Hypertension, December 1, 2007; 50(6): 1063 - 1068. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. G. Zenovich and D. A. Taylor CELL THERAPY IN KIDNEY DISEASE: CAUTIOUS OPTIMISM... BUT OPTIMISM NONETHELESS Perit. Dial. Int., June 1, 2007; 27(Supplement_2): S94 - S103. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J Ellul, P Talelli, G Terzis, A Chrysanthopoulou, G Gioldasis, and T Papapetropoulos Is the common carotid artery intima-media thickness associated with functional outcome after acute ischaemic stroke? J. Neurol. Neurosurg. Psychiatry, August 1, 2004; 75(8): 1197 - 1199. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. H. Dwyer, M. J. Paul-Labrador, J. Fan, A. M. Shircore, C. N. B. Merz, and K. M. Dwyer Progression of Carotid Intima-Media Thickness and Plasma Antioxidants: The Los Angeles Atherosclerosis Study Arterioscler Thromb Vasc Biol, February 1, 2004; 24(2): 313 - 319. [Abstract] [Full Text]
|
|
|
|
 |
|
 J. H. Dwyer, H. Allayee, K. M. Dwyer, J. Fan, H. Wu, R. Mar, A. J. Lusis, and M. Mehrabian Arachidonate 5-Lipoxygenase Promoter Genotype, Dietary Arachidonic Acid, and Atherosclerosis N. Engl. J. Med., January 1, 2004; 350(1): 29 - 37. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. R. Alexander, J. W. Knowles, T. Nishikimi, and N. Maeda Increased Atherosclerosis and Smooth Muscle Cell Hypertrophy in Natriuretic Peptide Receptor A-/-Apolipoprotein E-/- Mice Arterioscler Thromb Vasc Biol, June 1, 2003; 23(6): 1077 - 1082. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. Drueke, V. Witko-Sarsat, Z. Massy, B. Descamps-Latscha, A. P. Guerin, S. J. Marchais, V. Gausson, and G. M. London Iron Therapy, Advanced Oxidation Protein Products, and Carotid Artery Intima-Media Thickness in End-Stage Renal Disease Circulation, October 22, 2002; 106(17): 2212 - 2217. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 I. GOUNI-BERTHOLD and A. SACHINIDIS Does the coronary risk factor low density lipoprotein alter growth and signaling in vascular smooth muscle cells? FASEB J, October 1, 2002; 16(12): 1477 - 1487. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. M. Dwyer, C. K. Nordstrom, C. N. Bairey Merz, and J. H. Dwyer Carotid Wall Thickness and Years Since Bilateral Oophorectomy: The Los Angeles Atherosclerosis Study Am. J. Epidemiol., September 1, 2002; 156(5): 438 - 444. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. GLICK Screening for traditional risk factors for cardiovascular disease: A review for oral health care providers J Am Dent Assoc, March 1, 2002; 133(3): 291 - 300. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
J. H. Dwyer, M. Navab, K. M. Dwyer, K. Hassan, P. Sun, A. Shircore, S. Hama-Levy, G. Hough, X. Wang, T. Drake, et al. Oxygenated Carotenoid Lutein and Progression of Early Atherosclerosis : The Los Angeles Atherosclerosis Study Circulation, June 19, 2001; 103(24): 2922 - 2927. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. A. Matthews, L. H. Kuller, K. Sutton-Tyrrell, Y.-F. Chang, G. E. Tietjen, and R. L. Brey Changes in Cardiovascular Risk Factors During the Perimenopause and Postmenopause and Carotid Artery Atherosclerosis in Healthy Women Editorial Comment : Premenopausal Risk Continuum for Carotid Atherosclerosis After Menopause Stroke, May 1, 2001; 32(5): 1104 - 1111. [Abstract] [Full Text] [PDF]
|
|