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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:1951.)
© 2004 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Segment-Specific Effects of Cardiovascular Risk Factors on Carotid Artery Intima-Medial Thickness in Women at Midlife

Laura L. Schott; Rachel P. Wildman; Sarah Brockwell; Laurey R. Simkin-Silverman; Lewis H. Kuller; Kim Sutton-Tyrrell

From the Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pa.

Correspondence to Laura L. Schott, Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, 127 Parran Hall, 130 DeSoto Street, Pittsburgh, PA 15261. E-mail schottl{at}edc.pitt.edu

Objective— We investigated associations between segment-specific carotid intima-medial thickness (IMT) and cardiovascular risk factors collected before menopause for insight into mechanisms of atherosclerosis development.

Methods and Results— Participants were 453 healthy women (aged 46 to 58 years) enrolled in a dietary and physical activity randomized clinical trial. Ultrasound scan measures were taken 2.7 years after baseline in the common carotid artery (CCA), bifurcation (bulb), and internal carotid artery (ICA) segments. When scanned, 84% remained premenopausal. In linear regression models adjusted for age, menopausal status, and intervention group, measures independently (P<0.05) and positively associated were as follows: baseline weight (ß=0.007 per 5 kg), systolic blood pressure (SBP; ß=0.008 per 10 mm Hg), and age (ß=0.02 per 5 years) with CCA IMT; smoking (ß=0.08), weight (ß=0.009), and SBP (ß=0.02) with bulb IMT; and apoprotein B (ß=0.01 per 0.1 g/L) with ICA IMT. Differential effects in a repeated measures model with all 3 IMT locations showed these risk factors to have segment-specific positive associations. The effect of weight was strongest in the CCA, smoking and SBP were specific to the bulb, and apoprotein B was strongest in the ICA segment.

Conclusion— Analyses indicate that cardiovascular risk factors may differentially affect IMT in the CCA, bulb, and ICA segments of healthy middle-aged women.

Associations between segment-specific intima-medial thickness and cardiovascular risk factors in middle-aged women were examined through ultrasound in the common, bifurcation, and internal carotid arteries. Segment-specific effects, indicating cardiovascular risk factors may differentially affect intima-medial thickness and were evident in regression models and a repeated measures model with all 3 locations.

Key Words: atherosclerosis • women • carotid artery • ultrasound • cardiovascular risk factors

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