TY - JOUR
T1 - Subclinical Atherosclerosis among Young and Middle-Aged Adults Using Carotid Intima-Media Thickness Measurements
AU - Jones, Deborah L.
AU - Rodriguez, Violeta J.
AU - Alcaide, Maria L.
AU - Barylski, Nicole
AU - Cabral, Digna
AU - Rundek, Tatjana
AU - Weiss, Stephen M.
AU - Kumar, Mahendra
N1 - Funding Information:
From the Departments of Psychiatry and Behavioral Sciences, Medicine, and Neurology, University of Miami School of Medicine, Miami, Florida. Correspondence to Dr Deborah Jones, Department of Psychiatry & Behavioral Sciences, University of Miami Miller School of Medicine, 1400 NW 10th Ave, Miami, FL 33136. E-mail: [email protected]. To purchase a single copy of this article, visit sma.org/smj-home. To purchase larger reprint quantities, please contact [email protected]. The contents of this publication are solely the responsibility of the authors and do not represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. This study was funded by National Institute on Drug Abuse grant no. R01DA034589, with support from the Miami Center for AIDS Research at the University of Miami Miller School of Medicine (National Institutes of Health grant no. P30AI073961). The authors did not report any financial relationships or conflicts of interest. Accepted April 26, 2017. Copyright © 2017 by The Southern Medical Association 0038-4348/0–2000/110-733 DOI: 10.14423/SMJ.0000000000000728
Publisher Copyright:
© Lippincott Williams & Wilkins.
PY - 2017/11/1
Y1 - 2017/11/1
N2 - Objectives The presence of atherosclerotic plaque in the carotid arteries is a strong predictor of cardiovascular disease (CVD). Research and data on CVD risk have been derived primarily from individuals aged 55 years or older, and assessment of CVD risk among young and middle-aged adults seldom has been studied. The use of ultrasonography to measure carotid intima-media thickness (IMT) and carotid plaque appears to have utility to detect subclinical atherosclerosis in asymptomatic adults. This study evaluated the presence of carotid plaque using ultrasonography among healthy young and middle-aged adults. Methods Participants were men and women recruited in Miami, Florida, and were 18 to 50 years old with no history of CVD. Participants underwent a general physical examination and carotid artery ultrasonography to evaluate carotid IMT and carotid plaque. Results From a total of 173 participants with a mean age of 34 years (standard deviation 8.9), 21.0% (95% confidence interval [CI] 15.0-27.2) were identified as having carotid plaque. IMT values ranged from 0.49 to 1.03 mm, with a mean value of 0.70 mm (standard deviation 0.09). In multivariable logistic regression older age (adjusted odds ratio [AOR] 1.08, 95% CI 1.01-1.16, P = 0.024) and cigarette smoking (AOR 2.67, 95% CI 1.02-7.00, P = 0.045) were associated with plaque, after controlling for IMT (AOR 2.55, 95% CI 1.40-4.65, P = 0.002). Conclusions Traditional CVD risk factors such as those evaluated in this study may fail to provide adequate predictive value of carotid atherosclerosis in younger populations with no history of CVD, because the majority of traditional risk factors identified in previous research were not associated with carotid plaque in this young sample. Further research assessing nontraditional risk factors among asymptomatic individuals is required, and the evaluation of IMT as an intervention tool to detect CVD risk in these asymptomatic populations is warranted.
AB - Objectives The presence of atherosclerotic plaque in the carotid arteries is a strong predictor of cardiovascular disease (CVD). Research and data on CVD risk have been derived primarily from individuals aged 55 years or older, and assessment of CVD risk among young and middle-aged adults seldom has been studied. The use of ultrasonography to measure carotid intima-media thickness (IMT) and carotid plaque appears to have utility to detect subclinical atherosclerosis in asymptomatic adults. This study evaluated the presence of carotid plaque using ultrasonography among healthy young and middle-aged adults. Methods Participants were men and women recruited in Miami, Florida, and were 18 to 50 years old with no history of CVD. Participants underwent a general physical examination and carotid artery ultrasonography to evaluate carotid IMT and carotid plaque. Results From a total of 173 participants with a mean age of 34 years (standard deviation 8.9), 21.0% (95% confidence interval [CI] 15.0-27.2) were identified as having carotid plaque. IMT values ranged from 0.49 to 1.03 mm, with a mean value of 0.70 mm (standard deviation 0.09). In multivariable logistic regression older age (adjusted odds ratio [AOR] 1.08, 95% CI 1.01-1.16, P = 0.024) and cigarette smoking (AOR 2.67, 95% CI 1.02-7.00, P = 0.045) were associated with plaque, after controlling for IMT (AOR 2.55, 95% CI 1.40-4.65, P = 0.002). Conclusions Traditional CVD risk factors such as those evaluated in this study may fail to provide adequate predictive value of carotid atherosclerosis in younger populations with no history of CVD, because the majority of traditional risk factors identified in previous research were not associated with carotid plaque in this young sample. Further research assessing nontraditional risk factors among asymptomatic individuals is required, and the evaluation of IMT as an intervention tool to detect CVD risk in these asymptomatic populations is warranted.
KW - cardiovascular disease
KW - carotid plaque
KW - intima-media thickness
KW - ultrasonography
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U2 - 10.14423/SMJ.0000000000000728
DO - 10.14423/SMJ.0000000000000728
M3 - Article
C2 - 29100226
AN - SCOPUS:85032457277
SN - 0038-4348
VL - 110
SP - 733
EP - 737
JO - Southern Medical Journal
JF - Southern Medical Journal
IS - 11
ER -