Relationship between cardiovascular risk factors and carotid elasticity in healthy young adults: the bogalusa heart study

Abstract

Decreased arterial elasticity, indicating abnormal vascular function, has been associated with increased risk of cardiovascular disease in middle and older-age individuals. This study was designed to explore the rela-tionships between carotid artery function and cardiovascular risk factors in young, healthy adults. A sample of 516 subjects aged 25–37 years (mean age 32 years, 71% white, 39% male) who participated in the Bogalusa Heart Study were examined. Arterial elasticity was measured from M-mode ultrasonography of the common carotid artery by calculation of Peterson's elastic modulus (Ep). Elevated values indicate deterioration in elasticity. Risk factor variables included in the analyses were age, race, gender, systolic (SBP) and diastolic blood pressures (DBP), LDL cholesterol, HDL cholesterol, triglycerides, total to HDL cholesterol ratio, BMI, waist circumference, insulin, glucose, heart rate times pulse pressure (PP) product, cigarette smoking and parental history of hypertension or diabetes. After controlling for age, blacks and males had higher Ep values (P<0.01). Males also had higher mean SBP and DBP levels (p<0.01) with blacks demonstrating higher mean SBP than whites (p<0.0001). Males had higher values than females and whites higher than blacks for total cholesterol, LDL cholesterol, VLDL cholesterol and triglyceride with males and whites having lower HDL cholesterol than females and blacks respectively (P<0.05). Black females had higher BMI and waist circumference than white females (p<0.001). In univariate analyses, all risk factor variables listed above except LDL cholesterol and HDL cholesterol were correlated with Ep (p<0.05). In multivariate analyses, the independent predictors of Ep were SBP, heart rate x PP, age, log of triglycerides and BMI explaining 38% of the variance. Subjects were grouped according to number of risk factors with elevated values (top race and gender specific quartile). There was a linear relationship (p<0.0001) between Ep and number (0, 1, 2, 3, 4 or more) elevated risk factor levels. Abnormal carotid artery elasticity is associated with elevations in levels of cardiovascular risk factors. Even in asymptomatic young adults, clustering of abnormal risk factor levels may predict decreased vascular function underscoring the need for beginning preventive measures early in life.