Abstract
With great interest we read the article by Rundek et al1 reporting, in a large and multiethnic population, that traditional vascular risk factors explain only 11% of the variance in carotid intima-media thickness (cIMT), with only an additional 5% explained by less traditional factors, including adiponectin, homocysteine, and inflammation. Despite the differences between cIMT protocols and population features among studies, >70% of the cIMT variance is consistently not explained by traditional risk factors.2 Besides ongoing research regarding the possible contribution of genetic determinants of IMT variance, made plausible by the heritable nature of the IMT trait, several environmental factors, including psychological factors such as depression, anger, and sustained anxiety, have been robustly shown to predict IMT and its progression, …
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