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Do individuals with autoimmune disease have increased risk of subclinical carotid atherosclerosis and stiffness?

A Correction to this article was published on 30 April 2021

This article has been updated


To explore the role of chronic inflammation inherent to autoimmune diseases in the development of subclinical atherosclerosis and arterial stiffness, this study recruited two population-based samples of individuals with and without autoimmune disease (ratio 1:5) matched by age, sex, and education level and with a longstanding (≥6 years) diagnosis of autoimmune disease. Common carotid intima-media thickness (IMT) and arterial distensibility and compliance were assessed with carotid ultrasound. Multivariable linear and logistic regression models were adjusted for 10-year cardiovascular risk. In total, 546 individuals with and without autoimmune diseases (91 and 455, respectively) were included. The mean age was 66 years (standard deviation 12), and 240 (43.9%) were women. Arterial stiffness did not differ according to the presence of autoimmune diseases. In men, the diagnosis of autoimmune diseases significantly increased common carotid IMT [beta-coefficient (95% confidence interval): 0.058 (0.009; 0.108); p value = 0.022] and the percentage with IMT ≥ 75th percentile [1.012 (0.145; 1.880); p value = 0.022]. Women without autoimmune disease were more likely to have IMT ≥ the 75th percentile [−2.181 (−4.214; −0.149); p value = 0.035], but the analysis of IMT as a continuous variable did not yield significant results. In conclusion, subclinical carotid atherosclerosis, but not arterial stiffness, was more common in men with autoimmune diseases. Women did not show significant differences in any of these carotid features. Sex was an effect modifier in the association between common carotid IMT values and the diagnosis of autoimmune diseases.

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The authors appreciate the System for the Development of Research in Primary Care (SIDIAP) database access, the expert review on autoimmune diseases by Dr. Albert Escola Campabadal, and revision of the English text by Elaine Lilly PhD.


Supported by grants from the Instituto de Salud Carlos III FEDER (CP12/03287, CP17/00012), Health Research Fund (FIS 2003/HERMES PI20471, PI070403, ETES: PI07/90415, FIS11/06765) and Principado de Asturias Regional Government (IDI-2018–000176). Partially supported with European Regional Development Fund funds and grants from Spain’s Ministerio de Ciencia, Innovación y Universidades (RTI2018–095232-B-C21) and the Generalitat de Catalunya (2017 SGR 1742).

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Correspondence to Maria Grau.

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Vila, M.d.M., Remeseiro, B., Igual, L. et al. Do individuals with autoimmune disease have increased risk of subclinical carotid atherosclerosis and stiffness?. Hypertens Res 44, 978–987 (2021).

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  • Atherosclerosis
  • Autoimmune Diseases
  • Cardiovascular Diseases
  • Carotid Intima-Media Thickness


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