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The relationship between carotid intima–media thickness and carotid plaque: a cohort study in China

Journal of Human Hypertension volume 34, pages 468–473 (2020)Cite this article

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Abstract

Both carotid intima–media thickness (cIMT) and carotid plaque (CP) quantified by B-mode ultrasound have been proposed as surrogate imaging biomarkers of subclinical atherosclerosis, while the relationship between cIMT and CP, whether cIMT evaluation in a given patient might allow for predicting the development of a carotid plaque, is still discussed controversially. We investigated the cross-sectional relationship between cIMT and CP, and the predictive value of cIMT for incident CP formation in 1078 subjects with mean age of 52 ± 5 years in a community based atherosclerosis cohort in Beijing. Participants underwent ultrasonography of bilateral carotid arteries and received vascular risk factor assessment at baseline and after a mean of 2.35 years follow-up. The prevalence of plaque was increased by 3.75-fold for upper quartile cIMT compare with the lower quartile even after adjustments for traditional risk factors at baseline. Among the 746 plaque-free subjects at baseline, 230 (31.0%) developed new CP. After adjusted for demographics and vascular risk factors, neither baseline cIMT nor the cIMT change from baseline to follow-up predicted incident CP. In conclusion, although cIMT associates with CP cross-sectionally, increased cIMT dose not independently predict future plaque development. Our data suggest that paying attention to the traditional risk factors might prevent subjects from developing carotid plaques regardless from IMT changes.

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References

  1. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein N, et al. Mannheim carotid intima–media thickness and plaque consensus (2004–2006–2011). An update on behalf of the advisory board of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th and 20th European Stroke Conferences, Mannheim, Germany, 2004, Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc Dis. 2012;34:290–6.

    Article  Google Scholar 

  2. Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986;74:1399–406.

    Article  CAS  Google Scholar 

  3. Spence JD. Ultrasound measurement of carotid plaque as a surrogate outcome for coronary artery disease. Am J Cardiol. 2002;89:10–15.

    Article  Google Scholar 

  4. Zureik M, Ducimetière P, Touboul PJ, Courbon D, Bonithonkopp C, Berr C, et al. Common carotid intima–media thickness predicts occurrence of carotid atherosclerotic plaques: longitudinal results from the Aging Vascular Study (EVA) study. Arterioscler Thromb Vasc Biol. 2000;20:1622–9.

    Article  CAS  Google Scholar 

  5. von Sarnowski B, Lüdemann J, Völzke H, Dörr M, Kessler C, Schminke U, et al. Common carotid artery intima–media thickness and Framingham risk score predict incident carotid atherosclerosis plaque formation: longitudinal results from the SHIP study (Study of Health In Pomerania). Stroke. 2010;41:2375–7.

    Article  Google Scholar 

  6. Rundek T, Gardener H, Della-Morte D, Dong C, Cabral D, Tiozzo E, et al. The relationship between carotid intima–media thickness and carotid plaque in the Northern Manhattan Study. Atherosclerosis. 2015;241:364–70.

    Article  CAS  Google Scholar 

  7. Ebrahim S, Papacosta O, Whincup P, Wannamethee G, Walker M, Nicolaides AN, 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;30:841–50.

    Article  CAS  Google Scholar 

  8. Fan F, Qi L, Jia J, Xu X, Liu Y, Yang Y, et al. Noninvasive central systolic blood pressure is more strongly related to kidney function decline than peripheral systolic blood pressure in a Chinese community-based population. Hypertension. 2016;67:1166–72.

    Article  CAS  Google Scholar 

  9. Cheng G, Fan F, Zhang Y, Qi L, Jia J, Liu Y, et al. Different associations between blood pressure indices and carotid artery damages in a community-based population of china. J Hum Hypertens. 2016;30:750–4.

    Article  CAS  Google Scholar 

  10. Al-Shali KZ, House AA, Hanley AJ, Khan HM, Harris SB, Zinman B, et al. Genetic variation in PPARG encoding peroxisome proliferator-activated receptor gamma associated with carotid atherosclerosis. Stroke. 2004;35:2036–40.

    Article  CAS  Google Scholar 

  11. Finn AV, Kolodgie FD, Virmani R. Correlation between carotid intimal/medial thickness and atherosclerosis: a point of view from pathology. Arterioscler Thromb Vasc Biol. 2010;30:177–81.

    Article  CAS  Google Scholar 

  12. Ferreira JP, Girerd N, Bozec E, Machu JL, Boivin JM, London GM, et al. Intima–Media thickness is linearly and continuously associated with systolic blood pressure in a population-based cohort (STANISLAS Cohort Study). J Am Heart Assoc. 2016;5:e003529.

    Article  Google Scholar 

  13. Moskau S, Golla A, Grothe C, Boes M, Pohl C, Klockgether T, et al. Heritability of carotid artery atherosclerotic lesions: an ultrasound study in 154 families. Stroke. 2005;36:5–8.

    Article  Google Scholar 

  14. Bonithonkopp C, Touboul PJ, Berr C, Leroux C, Mainard F, Courbon D, et al. Relation of intima–media thickness to atherosclerotic plaques in carotid arteries. The Vascular Aging (EVA) Study. Arterioscler Thromb Vasc Biol. 1996;16:310–6.

    Article  CAS  Google Scholar 

  15. Persson J, Formgren J, Israelsson B, Berglund G. Ultrasound-determined intima–media thickness and atherosclerosis. Direct indirect Valid Arterioscler Thromb. 1994;14:261–4.

    CAS  PubMed  Google Scholar 

  16. Li R, Duncan BB, Metcalf PA, Sharrett AR, Tyroler HA, Barnes R, et al. B-mode-detected carotid artery plaque in a general population. Atherosclerosis Risk in Communities (ARIC) Study Investigators. Stroke. 1994;25:2377–83.

    Article  CAS  Google Scholar 

  17. Rosfors S, Hallerstam S, Jensenurstad K, Zetterling M, Carlström C. Relationship between intima–media thickness in the common carotid artery and atherosclerosis in the carotid bifurcation. Stroke. 1998;29:1378–82.

    Article  CAS  Google Scholar 

  18. Prati P, Vanuzzo D, Casaroli M, Bader G, Mos L, Pilotto L, et al. Determinants of carotid plaque occurrence. A long-term prospective population study: the San Daniele Project. Cerebrovasc Dis. 2006;22:416–22.

    Article  Google Scholar 

  19. Eigenbrodt ML, Bursac Z, Tracy RE, Mehta JL, Rose KM, Couper DJ, et al. B-mode ultrasound common carotid artery intima–media thickness and external diameter: cross-sectional and longitudinal associations with carotid atherosclerosis in a large population sample. Cardiovasc Ultrasound. 2008;6:10–10.

    Article  Google Scholar 

  20. Johnsen SH, Fosse E, Joakimsen O, Mathiesen EB, Stensland-Bugge E, Njølstad I, et al. Monocyte count is a predictor of novel plaque formation: a 7-year follow-up study of 2610 persons without carotid plaque at baseline the Tromso Study. Stroke. 2005;36:715–9.

    Article  Google Scholar 

  21. Roman MJ, Naqvi TZ, Gardin JM, Gerhard-Herman M, Jaff M, Mohler E, et al. Clinical Application of Noninvasive Vascular Ultrasound in Cardiovascular Risk Stratification: A Report from the American Society of Echocardiography and the Society of Vascular Medicine and Biology. Vasc Med. 2006;19:943–54.

    Google Scholar 

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Acknowledgements

This study was supported by grants from the University of Michigan–Peking University Health Science Centre (UM-PUHSC) Joint Institute for Translational and Clinical Research (grant no: BMU20110177 and BMU20160530). This study was also supported by Beijing Lisheng Cardiovascular Health Foundation and Projects of National Natural Science Foundation of China (grant 81703288).

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Authors and Affiliations

  1. Department of Cardiology, Peking University First Hospital, Beijing, China

    Ying Yang, Fangfang Fan, Lan Gao, Xiaoning Han, Guanliang Cheng, Jia Jia, Baowei Zhang, Wei Ma, Yong Huo, Litong Qi & Yan Zhang

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  1. Ying Yang
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  3. Lan Gao
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  4. Xiaoning Han
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Correspondence to Litong Qi or Yan Zhang.

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Yang, Y., Fan, F., Gao, L. et al. The relationship between carotid intima–media thickness and carotid plaque: a cohort study in China. J Hum Hypertens 34, 468–473 (2020). https://doi.org/10.1038/s41371-019-0252-5

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