Compensatory increase in common carotid artery diameter. Relation to blood pressure and artery intima-media thickness in older adults. Cardiovascular Health Study.

BACKGROUND AND PURPOSE Common carotid artery (CCA) diameter is thought to increase as a consequence of hypertension and may increase as the thickness of the arterial wall increases. The purpose of this study was to determine CCA dimensions and correlate them with clinical features. METHODS We performed a cross-sectional, community-based study of adults 65 years of age and older, measuring inner and outer diameter of the CCA in vivo with carotid sonography. Findings were correlated against risk factors for atherosclerosis, CCA intima-media thickness (IMT), and echocardiographically determined left ventricular (LV) mass. RESULTS Independent variables showing strong positive associations with outer and inner CCA diameter included age, male sex, height, weight, and systolic blood pressure. As an independent variable, LV mass (r = .40 and r = .37, respectively; P < .00001) had a strong positive relation to inner and outer CCA diameters. The relationship between diameter and IMT was different. In a model that controlled for age, sex, and estimated LV mass, an increase of 1 mm in CCA IMT corresponded to a 1.9 mm increase in the outer diameter of the artery (P < .00001) but was not significantly related to the inner diameter (slope = +0.07 mm; P = .26). CONCLUSIONS Increase in the outer diameter of the CCA is associated with subject size, sex, age, echocardiographically estimated LV mass, and CCA IMT. Increases in internal diameter of the CCA have similar relationships but are not related to IMT. This supports the hypothesis that the human CCA dilates as the thickness of the artery wall increases.

[1]  A. Simon,et al.  Pulsed Doppler: Diameter, Blood Flow Velocity and Volumic Flow of the Brachial Artery in Sustained Essential Hypertension , 1981, Circulation.

[2]  Aric Invest.  The Atherosclerosis Risk in Communities (ARIC) Study: design and objectives. The ARIC investigators , 1989 .

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

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

[5]  L. Fried,et al.  Recruitment of adults 65 years and older as participants in the Cardiovascular Health Study. , 1993, Annals of epidemiology.

[6]  A. Master,et al.  Blood pressure in white people over 65 years of age. , 1958, Annals of internal medicine.

[7]  M E Safar,et al.  Pulsatile diameter and elastic modulus of the aortic arch in essential hypertension: a noninvasive study. , 1989, Journal of the American College of Cardiology.

[8]  B M Psaty,et al.  Use of sonography to evaluate carotid atherosclerosis in the elderly. The Cardiovascular Health Study. CHS Collaborative Research Group. , 1991, Stroke.

[9]  R A Kronmal,et al.  Thickening of the carotid wall. A marker for atherosclerosis in the elderly? Cardiovascular Health Study Collaborative Research Group. , 1996, Stroke.

[10]  R S Reneman,et al.  Carotid artery wall properties in normotensive and borderline hypertensive subjects of various ages. , 1988, Ultrasound in medicine & biology.

[11]  S Glagov,et al.  Shear stress regulation of artery lumen diameter in experimental atherogenesis. , 1987, Journal of vascular surgery.

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

[13]  R Rauramaa,et al.  Prevalence of carotid atherosclerosis and serum cholesterol levels in eastern Finland. , 1988, Arteriosclerosis.

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

[15]  D. Ku,et al.  Hemodynamics and atherosclerosis. Insights and perspectives gained from studies of human arteries. , 1988, Archives of pathology & laboratory medicine.

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

[17]  W. Young,et al.  Seminar on the quantitative aspects of atherosclerosisThe quantitation of atherosclerosis: I. Relationship to artery size∗ , 1960 .

[18]  C. Furberg,et al.  Reliability of longitudinal ultrasonographic measurements of carotid intimal-medial thicknesses. Asymptomatic Carotid Artery Progression Study Research Group. , 1996, Stroke.

[19]  R W Barnes,et al.  Ultrasonic Measurement of the Elastic Modulus of the Common Carotid Artery The Atherosclerosis Risk in Communities ( ARIC ) Study , 2005 .

[20]  G. Motté,et al.  Relationship between physical properties of the arterial system and left ventricular performance in the course of aging and arterial hypertension. , 1982, European heart journal.

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

[22]  H. S. Klopfenstein,et al.  Sex, age, and disease affect echocardiographic left ventricular mass and systolic function in the free-living elderly. The Cardiovascular Health Study. , 1995, Circulation.

[23]  P. Touboul,et al.  Factors of carotid arterial enlargement in a population aged 59 to 71 years: the EVA study. , 1996, Stroke.

[24]  D H Blankenhorn,et al.  A definition of the intima of human arteries and of its atherosclerosis-prone regions. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. , 1992, Circulation.

[25]  Z. Ben-ishay,et al.  Atherosclerosis and aging of the aorta in the adult Jewish population of Israel. An anatomic study. , 1962, The American journal of cardiology.

[26]  W. Young,et al.  The quantitation of atherosclerosis , 1960 .

[27]  D. Levy,et al.  Influence of contemporary versus 30-year blood pressure levels on left ventricular mass and geometry: the Framingham Heart Study. , 1991, Journal of the American College of Cardiology.

[28]  R. Kronmal,et al.  The Cardiovascular Health Study: design and rationale. , 1991, Annals of epidemiology.

[29]  P. Kligfield,et al.  Performance of primary and derived M-mode echocardiographic measurements for detection of left ventricular hypertrophy in necropsied subjects and in patients with systemic hypertension, mitral regurgitation and dilated cardiomyopathy. , 1986, The American journal of cardiology.

[30]  P Pignoli,et al.  Ultrasonographic measurement of the common carotid artery wall thickness in hypercholesterolemic patients. A new model for the quantitation and follow-up of preclinical atherosclerosis in living human subjects. , 1988, Atherosclerosis.