The structural characteristics of the wall of carotid arteries in older women and their prospective determinants in the population

   Purpose: To study the age gradient and prospective determinants of the structural characteristics of the arterial wall in the Novosibirsk population of older women (in the cross-sectional and prospective analysis).

   Methods and data source: Random population sample (338 women, 52–79 years) was examined with ultrasound of the carotid arteries (CA) and repeated epidemiological evaluation of CVD and risk factors. The materials of baseline survey performed at age of 45–69 years were used. The average follow-up period was of 8.5 years. We analyzed age gradient of carotid intima-media thickness (CIMT) and carotid atherosclerotic plaques (СP) and their association with risk factors in cross-sectional and prospective design.

   Results: The mean maximum CIMT was (M ± SE) 0.79 ± 0.01mm (75 ‰ = 0.89 mm), the frequency of CP – 54.2 %. CIMT increased by 0.06–0.07 mm by age decade, frequency CP increased from 31 % to 73 % in women aged 52–79 years old. In cross-sectional analysis CIMT was positively associated with age, SBP, history of diabetes with treatment. Prospective predictors CIMT were: age SBP and menopause, measured at age 45–69 years old. In cross-sectional analysis CP was positively associated with age, SBP, smoking, presence of CVD and negatively associated with alcohol intake. Prospective predictors of CP were age, SBP, LDL cholesterol and smoking, measured at age 45–69 years old.   

   Conclusion: In female Siberian population aged 52–79 the reference value of CIMT was 0.89 mm (corresponding to established criteria 0.90 mm). Age gradient of CIMT increase and CP frequency were calculated. The determinants of CIMT were age, systolic blood pressure, diabetes with treatment history (in older age) and the menopause (in middle age). The presence of CP were determined by age, systolic blood pressure, LDL cholesterol, and smoking (in middle and older age), and it was negative associated with alcohol intake and positively – with history of CVD (in older age). The study results can be used to improve prevention of atherosclerosis in women.

1. Рябиков А. Н. Толщина интимы-медии сонных артерий у женщин: связь с факторами риска сердечно-сосудистых заболеваний / А. Н. Рябиков, Ю. Ю. Уколова, С. К. Малютина // Атеросклероз. – 2013. – Т. 9, № 1. – С. 54–64.

2. Touboul P. J., Hennerici M. G., Meairs S. et al. Mannheim intima-media thickness consensus // Cere brovasc. Dis. 2004. Vol. 18. Р. 346–349.

3. Pignoli P., Tremoli E., Poli A. et al. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging // Circulation. 1986. Vol. 74. P. 1399–1406.

4. Bis J. C., Kavousi M., Franceschini N. et al. Meta-analysis of genome-wide association studies from the CHARGE consortium identifies common variants associated with carotid intima media thickness and plaque // Nat. Genet. 2012. Vol. 43, N 10. P. 940–946.

5. Mathiesen E. B., Johnsen S. H., Wilsgaard T. et al. Carotid plaque area and intima-media thickness in prediction of first-ever ischemic stroke: a 10-year follow-up of 6584 men and women: the Tromsø Study // Stroke. 2011. Vol. 42, N 4. P. 972–979.

6. Nambi V., Chambless L., Folsom A. R. et al. Carotid intima-media thickness and presence or absence of plaque improves prediction of coronary heart disease risk: the ARIC (Atherosclerosis Risk In Communities) study // J. Am. Coll. Cardiol. 2010 Vol. 55, N 15. P. 1600–1606.

7. Allan P. L., Mowbray P. I., Lee A. J., Fowkes F. G. Relationship between carotid intima-media thickness and symptomatic and asymptomatic peripheral arterial disease. The Edinburgh Artery Study // Stroke. 1997. Vol. 28. P. 348–353.

8. Gariepy J., Salomon J., Denarie N. et al. Sex and topographic differences in associations between large-artery wall thickness and coronary risk profile in a French working cohort: the AXA Study // Arterioscler. Thromb. Vasc. Biol. 1998. Vol. 18. P. 584–590.

9. Joensuu T., Salonen R., Winblad I. et al. Determinants of femoral and carotid artery atherosclerosis // J. Intern. Med. 1994. Vol. 236. P. 79–84.

10. Ando F., Takekuma K., Niino N., Shimokata H. Ultra sonic evaluation of common carotid intima-media thickness (IMT) –influence of local plaque on the relationship between IMT and age // J. Epidemiol. 2000. Vol. 10. P. 10–17.

11. Salonen J. T., Salonen R. Ultrasound B-mode imaging in observational studies of atherosclerotic progression // Circulation. 1993. Vol. 87. P. 56–65.

12. Рябиков А. Н. Возрастная динамика и гендерные особенности интимо-медиального комплекса артериальной стенки / А. Н. Рябиков, М. Н. Рябиков, С. К. Малютина; ред. Ю. П. Никитин // Вопросы атерогенеза. – Новосибирск, 2005. – С. 216–225.

13. Diez-Roux A. V., Nieto F. J., Comstock G. W. et al. The relationship of active and passive smoking to carotid atherosclerosis 12–14 years later // Prev. Med. 1995. Vol. 24. P. 48–55.

14. Lassila H. C., Tyrrell K. S., Matthews K. A. et al. Prevalence and determinants of carotid atherosclerosis in healthy postmenopausal women // Stroke. 1997. Vol. 28, N 3. P. 513–517.

15. Toikka J. O., Laine H., Ahotupa M. et al. Increased arterial intima-media thickness and in vivo LDL oxidation in young men with borderline hypertension // Hyper tension. 2000. Vol. 36. P. 929–933.

16. Sutton-Tyrrell K., Alcorn H. G., Herzog H. et al. Morbidity, mortality and antihypertensive treatment effects by extent of atherosclerosis in older adults with isolated systolic hypertension // Stroke. 1995. Vol. 26. P. 1319–1324.

17. Prati P., Vanuzzo D., Casaroli M. et al. Prevalence and determinants of carotid atherosclerosis in a general population // Stroke. 1992. Vol. 23. P. 1705–1711.

18. Рябиков А. Н. Структурные изменения артериальной стенки и миокарда в популяции по данным ультразвукового исследования: методологические аспекты, детерминанты и прогностическое значение: автореф. дис. … д-ра мед. наук / А. Н. Рябиков. – Новосибирск, 2006.

19. Bansal S., Buring S., Rifai N. et al. Fasting compared nonfasting triglycerides and risk cardiovascular events in women // JAMA. 2007. Vol. 298. P. 309–316.

20. Bonora E., Kiechl S., Willeit J. et al. Prevalence of insulin resistance in metabolic disorders: the Bruneck Study // Diabetes. 1998. Vol. 47, N 10. P. 1643–1652.