Gender-specific differences in carotid intima-media thickness and its progression over three years: A multicenter European study

Kozàkovà, M.; Palombo, C.; Morizzo, C.; Nolan, J.J.; Konrad, T.; Dekker, J.M.; Balkau, B.; Nilsson, P.M.

doi:10.1016/j.numecd.2011.04.006

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Gender-specific differences in carotid intima-media thickness and its progression over three years: A multicenter European study

M. Kozàkovà
- Department of Internal Medicine, University of Pisa, via Roma 67, 56126 Pisa, Italy
- On behalf of the RISC Investigators, for further details see Appendix.
- Corresponding author. Tel.: +39 050 553532; fax: +39 050 553235.
C. Palombo
- Department of Internal Medicine, University of Pisa, via Roma 67, 56126 Pisa, Italy
C. Morizzo
- Department of Internal Medicine, University of Pisa, via Roma 67, 56126 Pisa, Italy
J.J. Nolan
- Metabolic Research Unit, St. James’s Hospital, Trinity College Dublin, Ireland
- On behalf of the RISC Investigators, for further details see Appendix.
T. Konrad
- Institute fur Stoffwechselforschung, Eschersheimer Landstr. 10, 60322 Frankfurt am Main, Germany
- On behalf of the RISC Investigators, for further details see Appendix.
J.M. Dekker
- Department of Epidemiology and Biostatistics, EMGO VU University Medical Center, van der Boechorststraat 71081 BT Amsterdam, The Netherlands
- On behalf of the RISC Investigators, for further details see Appendix.
B. Balkau
- Center for Research in Epidemiology and Public Health, U1018 INSERM, 16 Avenue, Paul Vaillant Couturier, 94807 Villejuif, France
- On behalf of the RISC Investigators, for further details see Appendix.
P.M. Nilsson
- Department of Clinical Science, Lund University, University Hospital, Box 117, SE-221 00 Lund, Sweden
- On behalf of the RISC Investigators, for further details see Appendix.

Received 30 November 2010; received in revised form 30 March 2011; accepted 5 April 2011. published online 09 September 2011.
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Abstract

Background and aims

This multicentre European study evaluated, in a young-to-middle-aged healthy population without carotid atherosclerosis, the gender-related differences in carotid intima-media thickness (IMT) and its short-term (3-year) progression, and whether these differences are related to different vascular ageing rate, cardiovascular risk profile or different susceptibility to family predisposition to cardiovascular diseases (CVD).

Methods and results

366 men and 422 women (age between 30 and 60 years) underwent B-mode carotid ultrasound at baseline and after 3-year follow-up period. IMT in 3 carotid segments was higher in men than in women (p < 0.0001 for all segments). When evaluated according to age decade, differences between men and women disappeared in the 6th decade, as in this decade a 3-year IMT progression rate accelerated in women (p < 0.05 as compared to the 4th and 5th age decade). Age was a major determinant of baseline all-segment IMT in women; in men all-segment IMT was influenced by age and LDL-cholesterol. IMT progression did not correlate with established cardiovascular risk factors, their short-term changes or family predisposition to CVD. Yet, a 3-year IMT progression in common carotid artery (CCA) was higher in men (p = 0.01) and women (p < 0.01) in whom relative Framingham risk increased during the corresponding period.

Conclusion

This study provides reference values on IMT and its short-term progression in healthy young-to-middle-aged population, and demonstrates gender-related differences in the susceptibility of carotid wall to ageing and LDL-cholesterol. Increase in Framingham risk accelerated a short-term CCA IMT progression rate in both genders, whereas family predisposition to CVD did not influence carotid IMT.

Keywords: Carotid ultrasound, Gender, Menopause, Risk factors, Vascular ageing