(Circulation. 1999;100:838-842.)
© 1999 American Heart Association, Inc.
Clinical Investigation and Reports |
Increased Carotid Intimal-Medial Thickness and Coronary Calcification Are Related in Young and Middle-Aged Adults
The Muscatine Study
Presented in part at the 70th Scientific Sessions of the American Heart Association, Orlando, Fla, November 11, 1997, and published in abstract form (Circulation. 1997;96[suppl I]:I-475).
From the Division of Cerebrovascular Diseases (P.H.D.), Department of Neurology, Division of Biostatistics (J.D.D., L.T.M., R.M.L.), Department of Preventive Medicine and Environmental Health, and Division of Pediatric Cardiology (L.T.M., R.M.L.), Department of Pediatrics, University of Iowa College of Medicine, Iowa City, Iowa.
Correspondence to Patricia H. Davis, MD, Division of Cerebrovascular Diseases, Department of Neurology, University of Iowa College of Medicine, 200 Hawkins Dr, Iowa City, IA 52242. E-mail pdavis{at}uiowa.edu
Background—Increased carotid intimal-medial thickness (IMT) and coronary artery calcification (CAC) are used as 2 markers of early atherosclerosis. Our objectives were to assess whether increased IMT and CAC are related and to determine the relationship between cardiovascular risk factors and carotid IMT in young adults.
Methods and Results—A sample of 182 men and 136 women aged 33 to
42 years living in Muscatine, Iowa, underwent B-mode carotid ultrasound
to determine the mean of 12 measurements of maximal carotid IMT. CAC
was defined as calcification in the proximal coronary arteries
in 
3 contiguous pixels with a density of 130 HU. The mean IMT was
0.788 mm (SD 0.127) for men and 0.720 mm (SD 0.105) for
women. CAC was present in 27% of men and 14% of women and was
significantly associated with IMT in men (P<0.025) and
women (P<0.005). With multivariate
analysis, after adjustment for age, significant risk factors
for carotid IMT were LDL cholesterol
(P<0.001) and pack-years of smoking
(P<0.05) in men and LDL cholesterol
(P<0.001) and systolic blood pressure
(P<0.01) in women. These risk factors remained
significant after CAC was included in the multivariate
model.
Conclusions—There is an association between increased carotid IMT and CAC and between cardiovascular risk factors and increased IMT in young adults. Carotid IMT may provide information in addition to CAC that can be used to identify young adults with premature atherosclerosis.
Key Words: carotid arteries • ultrasonics • risk factors • arteriosclerosis • coronary disease
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