Significantly Greater Progression of Intima-Media Thickness of the Carotid Artery in Japanese American Men Than in White Men: The ERA JUMP Study

Abstract

Background Although Westernized lifestyle was associated with increased coronary heart disease (CHD) morbidity and mortality in first and second generation Japanese Americans; CHD mortality was reported to be lower in them than whites. Risk profile of CHD for third and fourth generation Japanese Americans is not known. We compared progression of CIMT between third or fourth generation Japanese Americans and whites. Methods Population-based samples of 473 men (Japanese Americans=227 and whites=246) aged 40–49 years at baseline and free of clinical cardiovascular disease were examined for CIMT at baseline (2002–06) and follow-up (2007–13). CIMT was read centrally at the University of Pittsburgh. Analysis of covariance was used to compare annualized progression of CIMT between Japanese Americans and whites, adjusting for cardiovascular risk factors and baseline CIMT. Results Progression of CIMT was significantly greater in Japanese Americans than whites both before and after adjusting for covariates (mean in μm/year [95% confidence interval]): 14.4 (12.3, 16.4) vs 9.8 (7.8, 11.7), P<0.05 and 15.1 (13.1, 17.1) vs 9.1 (7.2, 11.0), P<0.05, respectively. Age, total cholesterol/high-density lipoprotein-cholesterol, and diabetes in Japanese Americans and age, hypertension, and lipid medication in whites were significantly associated with progression of CIMT. Conclusions The significantly greater progression of CIMT in Japanese Americans than whites might suggest a higher burden of CHD in Japanese Americans than whites in the future. The current study identifies Japanese Americans as an important target group for prevention of CHD. Future research assessing carotid plaque in addition to CIMT is warranted.

Traditional Risk Factors are Causally Related to Carotid Intima-Media Thickness Progression: Inferences from Observational Cohort Studies and Interventional Trials

“…In fact, in a 5-years follow-up, C-IMTp was the lowest in subjects with normal glucose tolerance, greater in patients with impaired glucose tolerance, and the greatest in those with either known or newly diagnosed T2DM. These results are in line with other studies showing that baseline T2DM [4,9,16,17,[77][78][79] and onset of T2DM during follow-up [17] are associated with an increased C-IMTp. Studies performed solely in patients with T2DM [3,80] show an annual C-IMTp significantly higher than that reported in general populations.…”

“…Studies performed in different patient populations investigated also associations of C-IMTp with lipid ratios, lipoprotein species, apolipoproteins and modified lipoproteins. Significant direct associations were reported for TC/HDL-C [9,132], TG/HDL-C [132], ApoB/HDL-C [132], VLDL-C [135], VLDL1+2-C [135], ApoB levels [126] or ApoB/ApoA-I ratio [136].…”

“…Diagnosis of hypertension [4,8,9,[14][15][16] and blood pressure levels [4,7,13,19,75,77,[103][104][105][106] were both directly associated with C-IMTp, with one exception [81] (Table 9; supplementary material). Moreover, several blood pressure variables associated with C-IMTp differently [17,[107][108][109][110].…”