Background: Serum bilirubin is negatively associated with the development of coronary heart disease. In the present study, we have focused on the analysis of intima-media thickness (IMT) of the common carotid artery in hyper- and normobilirubinemic subjects. Methods: The study was performed on 111 men without manifested atherosclerosis. In all subjects, complete biochemical tests were determined along with the examination of IMT by carotid ultrasound. Results: The mean IMT in hyperbilirubinemic subjects as compared with controls was substantially lower (p = 0.017), and hyperbilirubinemic men also had very low age-adjusted prevalence odds ratios for having IMT above the 50th percentiles of controls, even after adjustment for selected vascular risk factors (p = 0.034). Conclusions: In the present study, we demonstrate the inverse relationship between serum bilirubin and IMT in healthy men.

Hyperlipidaemia, atherosclerotic plaques, increased IMT, ischaemic heart disease and neuropsychological disturbances were frequent in this group of former 2,3,7,8-TCDD workers. Hyperlipidaemia might have played an important role in most of these disorders. The level of 2,3,7,8-TCDD correlated with the highest level of triglycerides ( P=0.02) and cholesterol ( P=0.01) that was found during the 35-year follow-up. This group belongs to the most heavily 2,3,7,8-TCDD-exposed groups of workers, because the mean estimated concentration at the time of intoxication was approximately 5000 pg g(-1) plasma fat.

Contemporary methods of assessment of possible cardiovascular disease based on traditional risk factors are not perfect. Therefore new ways are sought. Simple and inexpensive methods include assessment of the blood pressure on the lower extremities above the ankles. The finding of a reduced ratio of the ankle-brachial blood pressure index (ABI) indicates atherosclerosis of the lower extremity arteries. ABI values of 0.9 or less are associated with a significantly increased risk of cardiovascular diseases (in particular myocardial infarction and stroke) that is independent of other risk factors. ABI assessment is a simple clinical examination and should be performed in middle-aged and elderly subjects with a medium and high cardiovascular risk in order to define more accurately their health status. Patients with reduced ABI of 0.9 or less are candidates for secondary preventive treatment for cardiovascular disease.

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