Factors of carotid arterial enlargement in a population aged 59 to 71 years: the EVA study.

BACKGROUND AND PURPOSE Factors of carotid arterial enlargement are not well known in general populations. The purpose of this study was to assess the cross-sectional associations of arterial wall lesions and cardiovascular risk factors with carotid lumen diameter in elderly subjects. METHODS B-mode ultrasound examinations of the carotid arteries and risk factor assessment were made in 1272 participants in the EVA (Etude sur le vieillissement artériel) Study, a longitudinal study designed to evaluate vascular and cognitive aging in men and women aged 59 to 71 years. Ultrasound examinations included measurements of intima-media thickness (IMT) and interadventitial and lumen diameters of the common carotid arteries and quantification of atherosclerotic plaques in extracranial carotid arteries. RESULTS Men showed greater IMT interadventitial and lumen diameters of the common carotid arteries than did women. In both sexes, common IMT and plaque score were positively associated with common interadventitial and lumen diameters. Stepwise multiple regression analysis showed that male sex, body height and weight, common IMT, plaque score, systolic blood pressure, and alcohol consumption were positively and independently related to lumen diameter. On the other hand, an independent negative association was observed between low density lipoprotein cholesterol and lumen diameter. CONCLUSIONS In 59- to 71-year-old subjects, increased IMT and atherosclerotic plaques were accompanied by an increase in lumen diameter of the common carotid arteries, indicating an overcompensation. Luminal enlargement observed with several risk factors and with high blood pressure in particular might be partially counteracted by high lipid levels.

[1]  J. Salonen,et al.  Ultrasonographically assessed carotid morphology and the risk of coronary heart disease. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[2]  M L Bots,et al.  Isolated systolic hypertension and vessel wall thickness of the carotid artery. The Rotterdam Elderly Study. , 1993, Arteriosclerosis and thrombosis : a journal of vascular biology.

[3]  T M Morgan,et al.  Remodeling of coronary arteries in human and nonhuman primates. , 1994, JAMA.

[4]  J. Salonen,et al.  Determinants of carotid intima‐media thickness: a population‐based ultrasonography study in Eastern Finnish men , 1991, Journal of internal medicine.

[5]  R. Levy,et al.  Estimation of the concentration of low-density lipoprotein cholesterol in plasma, without use of the preparative ultracentrifuge. , 1972, Clinical chemistry.

[6]  B. Fagerberg,et al.  Ultrasound evaluation of atherosclerotic manifestations in the carotid artery in high-risk hypertensive patients. Risk Intervention Study (RIS) Group. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[7]  L. Chambless,et al.  Carotid atherosclerosis measured by B-mode ultrasound in populations: associations with cardiovascular risk factors in the ARIC study. , 1991, American journal of epidemiology.

[8]  S. Laurent,et al.  Arterial alterations with aging and high blood pressure. A noninvasive study of carotid and femoral arteries. , 1993, Arteriosclerosis and thrombosis : a journal of vascular biology.

[9]  A. Zanchetti,et al.  Ultrasonographic evaluation of cardiac and vascular changes in young borderline hypertensives. , 1993, Cardiology.

[10]  O. Wiklund,et al.  Arterial wall thickness in familial hypercholesterolemia. Ultrasound measurement of intima-media thickness in the common carotid artery. , 1992, Arteriosclerosis and thrombosis : a journal of vascular biology.

[11]  A P Avolio,et al.  Effects of aging on changing arterial compliance and left ventricular load in a northern Chinese urban community. , 1983, Circulation.

[12]  M. O'Rourke,et al.  Arterial stiffness, systolic blood pressure, and logical treatment of arterial hypertension. , 1990, Hypertension.

[13]  P. Touboul,et al.  Prevalence and Determinants of Carotid Atherosclerosis in a General Population , 1992, Stroke.

[14]  Richard A. Kronmal,et al.  Distribution and Correlates of Sonographically Detected Carotid Artery Disease in the Cardiovascular Health Study , 1992, Stroke.

[15]  R. Pini,et al.  Parallel Cardiac and Vascular Adaptation in Hypertension , 1992, Circulation.

[16]  L H Kuller,et al.  Isolated systolic hypertension and subclinical cardiovascular disease in the elderly. Initial findings from the Cardiovascular Health Study. , 1992 .

[17]  A. Dart,et al.  Aortic distensibility in patients with isolated hypercholesterolaemia, coronary artery disease, or cardiac transplant , 1991, The Lancet.

[18]  P. Touboul,et al.  Use of monitoring software to improve the measurement of carotid wall thickness by B-mode imaging , 1992, Journal of hypertension. Supplement : official journal of the International Society of Hypertension.

[19]  D. Levy,et al.  Relation of alcohol intake to left ventricular mass: The Framingham Study. , 1991, Journal of the American College of Cardiology.

[20]  J. Salonen,et al.  Progression of carotid atherosclerosis and its determinants: a population-based ultrasonography study. , 1990, Atherosclerosis.

[21]  M. Mancini,et al.  Early changes of the arterial carotid wall in uncomplicated primary hypertensive patients. Study by ultrasound high-resolution B-mode imaging. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[22]  P Ducimetière,et al.  Relation of intima-media thickness to atherosclerotic plaques in carotid arteries. The Vascular Aging (EVA) Study. , 1996, Arteriosclerosis, thrombosis, and vascular biology.

[23]  C. Zarins,et al.  Compensatory enlargement of human atherosclerotic coronary arteries. , 1987, The New England journal of medicine.

[24]  A. Folsom,et al.  Relation of Carotid Artery Wall Thickness to Diabetes Mellitus, Fasting Glucose and Insulin, Body Size, and Physical Activity , 1994, Stroke.

[25]  P Pignoli,et al.  Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. , 1986, Circulation.

[26]  J. Witteman,et al.  Carotid intima-media wall thickness in elderly women with and without atherosclerosis of the abdominal aorta. , 1993, Atherosclerosis.

[27]  A. Simon,et al.  Evidence for in vivo carotid and femoral wall thickening in human hypertension. Groupe de Prévention Cardio-vasculaire en Médecine du Travail. , 1993, Hypertension.

[28]  L Guize,et al.  Risk factors for early carotid atherosclerosis in middle-aged French women. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.

[29]  P. Sorlie,et al.  Arterial Enlargement in the Atherosclerosis Risk in Communities (ARIC) Cohort: In Vivo Quantification of Carotid Arterial Enlargement , 1994, Stroke.

[30]  T. Els,et al.  Compensatory carotid artery dilatation in early atherosclerosis. , 1994, Circulation.

[31]  S Glagov,et al.  Differential enlargement of artery segments in response to enlarging atherosclerotic plaques. , 1988, Journal of vascular surgery.

[32]  A. Folsom,et al.  Alcohol consumption and ultrasonographically assessed carotid artery wall thickness and distensibility. The Atherosclerosis Risk in Communities (ARIC) Study Investigators. , 1993, Circulation.

[33]  A. Sharrett,et al.  Associations of lipoprotein cholesterols, apolipoproteins A-I and B, and triglycerides with carotid atherosclerosis and coronary heart disease. The Atherosclerosis Risk in Communities (ARIC) Study. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[34]  P. Boutouyrie,et al.  Common carotid artery stiffness and patterns of left ventricular hypertrophy in hypertensive patients. , 1995, Hypertension.

[35]  U. de Faire,et al.  Carotid intima-media thickness and plaque in borderline hypertension. , 1995, Stroke.

[36]  V. Poutanen,et al.  Relation of aortic stiffness to factors modifying the risk of atherosclerosis in healthy people. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[37]  P M Rautaharju,et al.  Arterial wall thickness is associated with prevalent cardiovascular disease in middle-aged adults. The Atherosclerosis Risk in Communities (ARIC) Study. , 1995, Stroke.

[38]  J. Toole,et al.  Relation of extent of extracranial carotid artery atherosclerosis as measured by B-mode ultrasound to the extent of coronary atherosclerosis. , 1991, Arteriosclerosis and thrombosis : a journal of vascular biology.