Age- and gender-specific gradient of arterial wall intima-media
Abstract
Arterial intima-media thickness (IMT) is qualitative and quantitative marker of generalized atherosclerosis as well as a predictor of CVD strongly associated with the presence and level of CVD risk-factors. In the frame of a Siberian WHO MONICA Project and European Project on Genes in Hypertension (EPOGH) the representative population sample aged 18-63 (6 58 pers., mean age - 41.9 yrs) was examined by standard epidemiological methods followed by high-resolution carotid ultrasonography. The mean age-standardized IMT in men was significantly higher than in women (0.64 + 0.007 vs 0.58 + 0.012, p < 0.001). The IMT range in men was of 0.30 1.70 mm, 10 %- and 90 % cut-off points of the IMT distribution were 0.50 and 0.90 mm, correspondently. In women IMT range was of 0.30-1.30 mm, 10 %- and 90 % cut-off points of the IMT distribution were 0.40 and 0.80 mm, respectively. IMT consequently increased by age in both sexes, and was more remarkable in men (p < 0.001). The growth of IMT by decade varied in men and women from 0.005 to 0.17 mm. The most intensive IMT increase was observed in men, particularly in 35-44 year decade, comparing to women. Carotid IMT in a Siberian city population is similar to ones in North American and some European populations (Netherlands, Germany) and is higher than in France and Japan. The mean IMT and its growth intensity are higher in men than in women up to the age of 55 when increase rate became equal in both sexes. The sex-specific differences in early atherosclerotic morphology revealed by ultrasound may contribute to excess of coronary risk in middle age Siberian men.
About the Authors
A. N. RyabikovRussian Federation
SB RAMS
Institute of Internal Medicine
Novosibirsk
M. N. Ryabiko
Russian Federation
SB RAMS
Institute of Internal Medicine
Novosibirsk
S. K. Malyutina
Russian Federation
SB RAMS
Institute of Internal Medicine
Novosibirsk
References
1. Вихерт А. М. Географическая патология атеросклероза / А. М. Вихерт [и др.] – Москва: Медицина, 1981. - 216 с.
2. Жданов В. С. Эволюция и патология атеросклероза у человека / В. С. Жданов, А. М. Вихерт, Н. Г. Стернби. – Москва: Триада-Х, 2002. - 144 с.
3. Bonithon-Kopp C., Touboul P.-J., Berr C. et al. Relation of intima-media thickness to atherosclerotic plaques in carotid arteries. The Vascular Aging (EVA) Study. Arteriosclerosis, Thrombosis, and Vascular Biology 1996; 16: 310-316.
4. Bots M. L., Breslau P. J., Briet E. et al. Cardivascular determinants of carotid artery disease: the Rotterdam Study. Hypertension 1992; 19: 717-720.
5. Bots M. L., Hoes A. W., Koudstaal P. L., Hofman A., Grobbee D. E. Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study. Circulation 1997; 96:1432-1437.
6. Bots M. L., Witteman J. C., Grobbe D. E. Carotid intima-media wall thickness in elderly women with and without atherosclerosis of the abdominal aorta. Atherosclerosis 1993; 102:99-105.
7. Denarie N., Simon A., Chironi G. et al. Difference in carotid artery wall structure between Swedish and French men at low and high coronary risk. Stroke 2001; 23: 1775-1779.
8. Ebrahim S., Papacosta O., Whincup P. et al. Carotid plaque, intima media thickness, cardiovascular risk factors, and prevalent cardiovascular disease in men and women. The British Regional Heart Study. Stroke 1999: 30: 841-850.
9. Grobbee D. E. & Bots M. L. Carotid artery intima-media thickness as an indicator of generalized atherosclerosis. J Int Med 1994; 236: 567-573.
10. Homma S., Hirose N., Ishida H., Ishii T., Araki G. Carotid plaque and intima-media thickness assessed by B-mode ultrasonography in subjects ranging from young adults to centenarians. Stroke 2001; 32: 830-835.
11. Howard G., Sharrett A. R., Heiss G. et al. Carotid artery intimal-medial thickness distribution in general populations as evaluated by B-mode ultrasound. ARIC Investigators. Stroke 1993 Sep; 24 (9) : 1297-304.
12. Joakimsen O., Banaa K. H., Stensland-Bugge E., Jacobsen B. K. Age and sex differences in the distribution and ultrasound morphology of carotid atherosclerosis. The Tromsa Study. Arterioscler Thromb Vasc Biol 1999; 19 : 3007 - 3013.
13. Jounala M., Viikari J. S. A., Laitinen T., Marniemi J., Helenius H., Ronnemaa T., Raitakari O. T. Interrelations between brachial endothelial function and carotid intima-media thickness in young adults. The Cardiovascular Risk in Young Finns Study. Circulation 2004; 110: 2918-2923.
14. O'Leary D. H., Polak J. F., Kronmal R. A., Manolio T. A., Burke G. L., Wolfson S. K. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collabo rative Research Group. N Engl J Med 1999; 340: 14-22.
15. O'Leary D. H., Polak J. F., Kronmal R. A., Savage P. J., Borhani N. O., Kittner S. J., Tracy R., Gardin J. M., Price T. R., Furberg C. D. Thickening of the carotid wall. A marker of atherosclerosis in elderly? Cardiovascular Health Study Collabora tive Research Group. Stroke 1996; 27: 224-231.
16. Raitakari O. T., Jounala M., Kahonen M., et al. Cardivascular risk factors in Childhood and carotid artery intima-media thicness in adulthood. The Cardiovascular Risk in young Finns study. JAMA 2003; 290: 2277-2283.
17. Salonen J. T., Salonen R. Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. Artherioscl Thromb 1991; 11: 1245-1249.
18. Schmidt-Trucksass A., Grathwohl D., Schmid A. et al. Structural, Functional, and hemodynamic changes of the common carotid artery with age in male subjects. Arterioscler Thromb Vasc Biol 1999; 19: 1091-1097.
19. Schott L. L., Wildman R. P., Brockwell S. et al. Segment-specific effects of cardiovascular risk factors on carotid artery intima-medial thickness in women at midlife. Arterioscler Thromb Vasc Biol 2004; 24: 1951-1956.
20. Stary H. C., Blankerhorn D. H., Chandler B., Glagov S., Insull W., Richardson M. et al. A definition of the intima of human arteries and of its atherosclerosis-prone regions. Arterioscler Thromb 1992; 12: 120-34.
Review
For citations:
Ryabikov A.N., Ryabiko M.N., Malyutina S.K. Age- and gender-specific gradient of arterial wall intima-media. Ateroscleroz. 2008;4(1):27-32. (In Russ.)