Higher Intima-media Thickness Values Research Articles

Surrogate markers of atherosclerosis: impact of statins.

Carotid artery intima-media thickness (IMT) measured by ultrasound has been shown to be correlated with existing cardiovascular disease (CVD) and predictive of CVD in individuals without clinically evident disease. Carotid IMT is now widely used as a surrogate marker for atherosclerotic disease. A number of studies have shown that lipid-lowering therapy with a statin can reduce or reverse carotid IMT progression. The METEOR trial (Measuring Effects on Intima-Media Thickness: an Evaluation Of Rosuvastatin) will examine the effects of aggressive lipid-lowering treatment with rosuvastatin on IMT in mildly hypercholesterolemic low-risk subjects with relatively high IMT values. The results will provide important information on the ability to achieve regression of abnormal IMT with robust reductions in low-density lipoprotein (LDL) cholesterol levels to below current target levels. Another study will examine the effects of potent LDL cholesterol reduction with rosuvastatin in young patients with heterozygous familial hypercholesterolemia (FH). Patients with FH are at increased risk of premature coronary heart disease in association with marked LDL cholesterol elevations, exhibiting a rate of progression of IMT 5x greater than that of low-risk controls without the disorder and early intervention may be the optimal approach to modifying atherosclerosis progression in these patients.

Factors Underlying the Increase in Carotid Intima-Media Thickness in Borderline Hypertensives

To define the role played by various risk and behavioral factors in the increase of carotid intima-media thickness (IMT) observed in borderline hypertensives. Using B-mode ultrasonography, we compared 97 borderline hypertensives enrolled in the HARVEST study to 27 normotensive controls. Intima-media thickness was measured in the right and left common carotid artery, bulb, and internal carotid artery. Mean IMT (m-IMT), maximum IMT (M-IMT), the mean of M-IMT (M-MAX), and the prevalence of raised lesions (IMT>1 mm) were established. Compared to the controls, higher systolic BP, diastolic BP, mean arterial blood pressure levels and body mass index (BMI) were present in the borderline hypertensives, whereas age, smoking, physical activity, serum cholesterol, and triglycerides were similar. After adjusting for age, sex, heart rate, BMI, smoking, serum cholesterol, triglycerides, and physical activity, higher values of m-IMT and M-IMT were present in most carotid segments of borderline hypertensives compared with controls. After further adjustment for systolic BP and diastolic BP, differences were no longer significant. The adjusted M-MAX was 0.59+/-0.12 in borderline hypertensives compared with 0.50+/-0.10 in controls (P<0.001). After adjustment for systolic BP and diastolic BP it was 0.58+/-0.11 in borderline hypertensives compared with 0.50+/-0.12 in controls (P<0.005). In the various carotid segments, the prevalence of raised lesions was 1. 2% in borderline hypertensives compared with 0.3% in controls (P<0. 001). In the multivariate analysis m-IMT, M-IMT, and M-MAX were related to ambulatory mean arterial pressure, systolic BP and diastolic BP, serum cholesterol and triglycerides, BMI, age, and physical activity. Higher IMT values were found in subjects who were physically active than in those who were sedentary. In borderline hypertensives, an increase in IMT takes place not only in the common carotid artery but also in the bulb and the internal carotid segment. Blood pressure levels are a main determinant of m-IMT while the interaction of BP with other risk factors such as age and plasma lipids is more relevant for advanced intima-media thickening such as M-MAX.

Increased carotid arterial wall thickness in common hyperlipidemia

Intima-media thickness has been reported to be increased in several patients with disorders such as diabetes mellitus, systolic hypertension and familial hypercholesterolemia. No data are available for the less severe but more frequent forms of hyperlipidemia. The aim of the present study was to compare the intima-media thickness in men with mild to moderate hyperlipidemia with that in age- and sex-matched normolipidemic controls. Fifty hyperlipidemic patients and 50 controls were enrolled in this study. Intima-media thickness was evaluated from high-resolution B-mode echo-Doppler images. Blood lipids and glucose were measured using standard methods. Cigarette consumption was recorded by questionnaire. Intima-media thickness was significantly higher in hyperlipidemic patients than in controls. Smokers, both hyperlipidemic and controls, had higher values of intima-media thickness, although not significantly so, than non-smokers. The distribution of intima-media thickness values ranged from 0.52 to 1.24 mm in hyperlipidemic patients and from 0.46 to 0.82 mm in controls. Eighteen patients with hyperlipidemia had an intima-media thickness larger than 0.82 mm and, of these, 14 had atherosclerotic plaques in the carotid arteries. Furthermore, 11 hyperlipidemic patients showed signs of cardiovascular disease and had significantly enlarged intima-media thickness compared with participants without cardiovascular disease. Intima-media thickness in the common carotid artery is enlarged in patients with mild to moderate forms of hyperlipidemia and the highest values of intima-media thickness are frequently associated with atherosclerotic plaques in the carotid arteries and signs of cardiovascular disease.