Abstract
Arterial diameter is an underutilized indicator of vascular health. We hypothesized that interadventitial and lumen diameter of the common carotid artery would be better indicators of vascular health than carotid plaque or intima media thickness (IMT). Participants were 491 overweight or obese, postmenopausal women who were former or current hormone therapy (HT) users, 52–62 years, with waist circumference >80 cm. We evaluated cross-sectional associations of cardiovascular risk factors with carotid measures, by HT status. Former HT users had a worse cardiovascular profile than current HT users: larger adventitial (6.94 mm versus 6.79 mm) and lumen diameter (5.44 mm versus 5.31 mm, both P < 0.01) independent of cardiovascular risk factors; IMT and plaque were similar. Larger diameters were best explained by former HT use, higher pulse pressure, and greater weight. Independent of potential confounders, overweight and obese postmenopausal former HT users had larger carotid diameters than current HT users. Carotid diameter should be considered in studies of HT.
Highlights
Until recently, the adventitia has been largely neglected [1, 2]
Simple linear regression showed that in addition to former hormone therapy (HT) use, larger interadventitial diameter (IAD) was significantly associated with greater systolic blood pressure, pulse pressure, body mass index (BMI), weight, height, waist circumference, glucose, insulin, age, Caucasian race, current nonsmoking status and use of antihypertensive medications (P < 0.05) (Table 3)
Hormone therapy, pulse pressure, and weight remained significantly associated with IAD
Summary
The adventitia has been largely neglected [1, 2]. The adventitia is more than just the outermost layer of the artery; it is known to play a critical role in vascular remodeling and other important processes of the artery [1,2,3]. Recent attention to the role of the adventitia in vascular remodeling has increased reporting of common carotid artery interadventitial diameter (IAD), a noninvasive measure of vascular geometry and health. The study found lower levels of estradiol were significantly associated with larger common carotid artery IAD even after adjustment for cardiovascular risk factors [4]. Other studies have shown that larger IAD is associated with increasing age [5,6,7], cardiovascular risk factors [4,5,6, 8,9,10,11,12,13], prevalent cardiovascular disease [12, 14, 15], and incident cardiovascular events [15]. The increase in IAD observed with declining endogenous estrogen [4] suggests that lower levels of endogenous estrogens are associated with a less healthy vasculature
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