Site-Specific Atherosclerotic Plaques in the Carotid Arteries of Middle-Aged Women From Southern Italy

Abstract

Background and Purpose-Studies on cardiovascular disease have preferentially involved men because of the lower frequency of the disease in preelderly women. The aim of this analysis was to examine, with the use of a standardized ultrasound protocol, a cohort of women to differentiate early atherosclerotic lesions in different carotid segments in relation to traditional (lipoprotein abnormalities, high blood pressure, cigarette smoking) and nontraditional (oxidation markers) cardiovascular risk factors. Methods-More than 5000 clinically healthy, middle-aged women (nϭ5062; age range, 30 to 69 years) living in the area of Naples in southern Italy participated in the Progetto Atena, a population-based study on the etiology of cardiovascular disease and cancer in the female population. A subsample of 310 participants underwent high-resolution B-mode ultrasound to assess intima-media thickness of common carotid artery and carotid bifurcation. Results-Early atherosclerotic plaques (intima-media thickness Ͼ1.2 mm) were detected within the common carotid arteries in 37 women, in the carotid bifurcations in 77 women, and in both sites in 91 women. After age adjustment, common carotid plaques were found to be associated with higher systolic blood pressure (143 versus 138 mm Hg; PϽ0.05) and higher body mass index (29 versus 27 kg/m 2 ; PϽ0.01), while lesions at the carotid bifurcations were associated with higher LDL cholesterol (4.3 versus 3.8 mmol/L; PϽ0.01) and with smoking habit. Multivariate odds ratios for the presence of common carotid plaques were related to antibodies against oxidized LDL (odds ratio, 2.72; 95% CI, 1.46 to 5.07), and those for plaques at the bifurcation were related to lipid peroxides (odds ratio, 1.90; 95% CI, 1.04 to 3.47), and both relationships were independent of age, LDL cholesterol concentrations, body mass index, smoking habit, and systolic blood pressure. Conclusions-In a cohort of clinically healthy, middle-aged women, we found a site-specific association of traditional risk factors and oxidation markers with early atherosclerotic lesions in arterial segments differing in geometry, shear stress, extracellular matrix composition, and cell type populations.

Association of Carotid Artery Atherosclerosis With Circulating Biomarkers of Extracellular Matrix Remodeling: The Framingham Offspring Study

“…(14) Another study showed an association of elevated LDL cholesterol and cigarette smoking with plaques at the carotid bifurcation, whereas higher systolic blood pressure and body mass index (BMI) were associated with common carotid artery plaques. (15) In addition, the predictive value of measures of atherosclerosis may vary according to the site of measurement. For instance, internal carotid IMT has been shown to be a better predictor of myocardial infarction compared to measures in the common carotid artery, whereas the combined measurement (common and internal carotid IMT) was better predictor of stroke in a prior study.…”

Association of Obesity and Central Fat Distribution With Carotid Artery Wall Thickening in Middle-Aged Women

“…9 -12 Over the last decade, high-resolution B-mode ultrasound has been used for the noninvasive assessment of carotid intima-media thickness (IMT), a marker of early atherosclerosis. [13][14][15][16] Recently, cross-sectional carotid intimamedia (IM) area, a parameter that incorporates changes in both vessel wall and lumen diameter, has been demonstrated to be another accurate predictor of coronary atherosclerosis. 17 In the present analysis, we sought to determine whether general and abdominal obesities were associated with common carotid wall thickening in a sample of middle-aged women from Southern Italy participating in a large, ongoing, prospective study (Progetto ATENA study) designed to investigate the causes of those chronic diseases (cardiovascular disease and cancer) that have a major impact on the female population.…”

Radical-Trapping Activity, Blood Pressure, and Carotid Enlargement in Women

“…A description of the method has been published elsewhere. 14 The total radical-trapping activity potential of plasma (TRAP), which is indicative of plasma antioxidant potential, was measured with the use of a spectrophotometric end-point method 20,21 on a Cobas Fara centrifugal analyzer (Roche). The error of the method was evaluated by daily analyzing a plasma pool and was Ͻ5%.…”

“…[11][12][13] A recent study demonstrated a site-specific association of traditional risk factors and oxidation markers with early atherosclerotic lesions of the carotid arteries. 14 In this study, we examined a cohort of middle-aged women by using high-resolution B-mode ultrasound to measure arterial thickness parameters and carotid diameters, to have an estimate of carotid artery enlargement in response to wall thickening, and to evaluate the impact of traditional (blood pressure, body mass index, hyperlipidemia) and nontraditional risk factors (serum oxidative markers) on this process. …”