Abstract 245: Metabolic Syndrome and Common Carotid Artery Remodeling: Study of Women’s Health Across the Nation

Abstract

Objective The metabolic syndrome (MetS) is linked to a higher risk of cardiovascular disease (CVD) events, including stroke. Measures of maladaptive carotid artery remodeling such as greater common carotid artery (CCA) intima-media thickness (IMT), and wider adventitial diameter (AD) are more prevalent among older women, varies by race/ethnicity and is predictive of stroke, however, data are lacking in women during the menopausal transition. Thus, we hypothesized more maladaptive carotid remodeling among MetS than those without MetS by race/ethnicity. Methods Study of Women’s Health Across the Nation (SWAN) participants, free of clinical CVD and with IMT and AD data at the 12th annual visit were evaluated. Lumen diameter (LD), circumferential wall stress (CWS) and circumferential wall tension (CWT) were calculated. Multivariable linear regressions were used to investigate the relationship between MetS and CCA parameters in all women and by race/ethnicity. Covariates included were age, height, site, LDL-c, education, medication use, menopause status and smoking. Results A total of 1183 women (41.3% MetS; 96.9% Postmenopausal; 52.1% Caucasian, 27.6% African American, 14.6% Chinese, 5.8% Hispanic) from 6 sites across the USA, aged 60.1±2.7 years old at visit 12 were included. MetS was associated with a larger LD (β(SE)): 0.222(0.033) mm, P <0.0001; AD (0.317(0.038)) mm, P <.0001; IMT(0.047(0.006)) mm, P <.0001; CWS (2.51(0.938)) kPa, P <.0077; CWT (5.53(0.637) kPa, P <.0001), after adjusting for covariates. Compared to Caucasians, LD was greater in both African American and Chinese ( (0.130 (0.040) mm, P <.0001; 0.292(0.064) mm, P<.0001, respectively), AD was greater in African American ((0.236(0.046) mm, P <.0001) and Chinese ((0.331(0.073) mm, P <.0001), a thicker IMT((0.053(0.008) mm, P <.0001), CWT was greater for African American and Chinese ((4.83(0.776) kPa, P <.0001; 3.18(1.22) kPa, P =0.0093). Conclusion MetS is associated with maladaptive remodeling of the CCA, as evidenced by larger AD, LD, IMT and CWT. Importantly, the association between MetS and CCA remodeling varies between race/ethnicity, which could partially explain differences in stroke rates by race.