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Carotid arterial wall characteristics are associated with incident ischemic stroke but not coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) study.

TitleCarotid arterial wall characteristics are associated with incident ischemic stroke but not coronary heart disease in the Atherosclerosis Risk in Communities (ARIC) study.
Publication TypeJournal Article
Year of Publication2012
AuthorsYang EY, Chambless L, Sharrett ARichey, Virani SS, Liu X, Tang Z, Boerwinkle E, Ballantyne CM
Secondary AuthorsNambi V
JournalStroke
Volume43
Issue1
Pagination103-8
Date Published2012 Jan
ISSN1524-4628
KeywordsAtherosclerosis, Brain Ischemia, Carotid Arteries, Carotid Intima-Media Thickness, Cohort Studies, Coronary Disease, Female, Humans, Incidence, Male, Middle Aged, Prospective Studies, Risk Factors, Stroke
Abstract

BACKGROUND AND PURPOSE: Ultrasound measurements of arterial stiffness are associated with atherosclerosis risk factors, but limited data exist on their association with incident cardiovascular events. We evaluated the association of carotid ultrasound-derived arterial stiffness measures with incident coronary heart disease (CHD) and ischemic stroke in the Atherosclerosis Risk in Communities (ARIC) study.

METHODS: Carotid arterial strain and compliance, distensibility and stiffness indices, pressure-strain, and Young elastic moduli were measured in 10 407 individuals using ultrasound. Hazard ratios for incident CHD (myocardial infarction, fatal CHD, coronary revascularization) and stroke in minimally adjusted (age, sex, center, race) and fully adjusted models (minimally adjusted model+diabetes, height, weight, total cholesterol, high-density lipoprotein cholesterol, tobacco use, systolic blood pressure, antihypertensive medication use, and carotid intima-media thickness) were calculated.

RESULTS: The mean age was 55.3 years. Over a mean follow-up of 13.8 years, 1267 incident CHD and 383 ischemic stroke events occurred. After full adjustment for risk factors and carotid intima-media thickness, all arterial stiffness parameters (carotid arterial strain hazard ratio [HR], 1.14 [95% CI, 1.02-1.28]; arterial distensibility HR, 1.19 [1.02-1.39]; stiffness indices HR, 1.14 [1.04-1.25]; pressure-strain HR, 1.17 [1.06-1.28]; Young elastic moduli HR, 1.13 [1.03-1.24]), except arterial compliance (HR, 1.02 [0.90-1.16], were significantly associated with incident stroke but not with CHD.

CONCLUSIONS: After adjusting for cardiovascular risk factors, ultrasound measures of carotid arterial stiffness are associated with incident ischemic stroke but not incident CHD events despite that the 2 outcomes sharing similar risk factors.

CLINICAL TRIAL REGISTRATION: URL: www.clinicaltrials.gov. Unique identifier: NCT00005131.

DOI10.1161/STROKEAHA.111.626200
Alternate JournalStroke
PubMed ID22033999
PubMed Central IDPMC3246524
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
K23 HL096893-03 / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100005C / / PHS HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100009C / / PHS HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
HHSN268201100010C / / PHS HHS / United States
T32 HL007812 / HL / NHLBI NIH HHS / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / / PHS HHS / United States
HHSN268201100012C / / PHS HHS / United States
K23 HL096893 / HL / NHLBI NIH HHS / United States
T32HL007812 / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / / PHS HHS / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100011C / / PHS HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
HHSN268201100006C / / PHS HHS / United States