Prevalence and determinants of carotid plaque in the cross-sectional REFINE-Reykjavik study

ObjectiveCarotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common car...

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Published in:BMJ open Vol. 6; no. 11; p. e012457
Main Authors: Sturlaugsdottir, Ran, Aspelund, Thor, Bjornsdottir, Gudlaug, Sigurdsson, Sigurdur, Thorsson, Bolli, Eiriksdottir, Gudny, Gudnason, Vilmundur
Format: Journal Article
Language:English
Published: England BMJ Publishing Group LTD 01.11.2016
BMJ Publishing Group
Subjects:
Adult
Age
Age Distribution
Angioplasty
Antihypertensives
Atherosclerosis
Atherosclerosis - diagnostic imaging
Atherosclerosis - epidemiology
Blood Pressure
Body mass index
Cardiovascular disease
Carotid arteries
Carotid Artery, Common - diagnostic imaging
Carotid Intima-Media Thickness
Cholesterol
Cholesterol - blood
Cross-Sectional Studies
Diabetes
Diabetes Mellitus, Type 2 - complications
Epidemiology
Family medical history
Fasting
Female
Glucose
High density lipoprotein
Humans
Hypertension
Iceland - epidemiology
Logistic Models
Male
Middle Aged
Questioning
Risk Factors
Sex Distribution
Smoking - adverse effects
Ultrasonic imaging
Veins & arteries
Womens health
atherosclerosis
type 2 diabetes mellitus
risk factors
carotid arteries
ISSN:2044-6055, 2044-6055
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Summary:ObjectiveCarotid plaque and intima-media thickness are non-invasive arterial markers that are used as surrogate end points for cardiovascular disease. The aim was to assess the prevalence and severity of carotid plaque, and examine its determinant risk factors and their association to the common carotid artery intima-media thickness (CCA-IMT) in a general population.MethodsWe examined 6524 participants aged 25–69 years in the population-based REFINE (Risk Evaluation For INfarct Estimates)-Reykjavik study. Plaques at the bifurcation and internal carotid arteries were evaluated. Mean CCA-IMT was measured in the near and far walls of the common carotid arteries.ResultsThe prevalence of minimal, moderate and severe plaque was 35.0%, 8.9% and 1.1%, respectively, and the mean CCA-IMT was 0.73 (SD 0.14) mm. Age, sex, smoking and type 2 diabetes mellitus (T2DM) were the strongest risk factors associated with plaque, followed by systolic blood pressure, total cholesterol, body mass index and family history of myocardial infarct. Low educational level was also strongly and independently associated with plaque. CCA-IMT shared the same risk factors except for a non-significant association with T2DM and family history of myocardial infarction (MI). Participants with T2DM had greater plaque prevalence, 2-fold higher in those <50 years and 17–30% greater in age groups 50–54 to 60–64, and more significant plaques (moderate or severe) were the difference in prevalence was 24% in age group 50–54 and ≥60% in older age groups, compared with non-T2DM.ConclusionsCarotid plaque and CCA-IMT have mostly common determinants. However, T2DM and family history of MI were associated with plaque but not with CCA-IMT. Greater prevalence and more severe plaques in individuals with T2DM raise the concern that with increasing prevalence of T2DM we may expect an increase in atherosclerosis and its consequences.
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ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2016-012457