Socioeconomic differences in progression of carotid intima-media thickness in the Atherosclerosis Risk in Communities study.
OBJECTIVE
To examine the association of socioeconomic factors with progression of carotid intimal-medial thickness (IMT) in middle-aged adults. Cross-sectional associations of IMT with socioeconomic status (SES) have been demonstrated in middle-aged cohorts. It is unclear whether these factors are associated with progression of IMT.


RESULTS
We examined IMT progression over 9 years among a middle-aged cohort of 12,085 black and white subjects free of cardiovascular disease recruited from 4 US sites participating in the Atherosclerosis Risk in Communities (ARIC) study. Baseline IMT was inversely related to SES among whites and blacks. Repeated measures regression models of IMT progression showed moderate inverse relationships of IMT progression with income in whites so that the difference in 5-year IMT progression rates between the highest and lowest categories was -11.5 microm (CI, -17.4 to -5.6). In contrast, among blacks, this gradient is reversed, with an 11.1 microm (CI, -0.1 to 22.3) difference in 5-year progression between highest and lowest income category. Generally, similar patterns were observed for other socioeconomic indicators. Patterns were not accounted for by baseline cardiovascular risk factors.


CONCLUSIONS
SES is inversely related to IMT progression in middle-aged whites but positively related to IMT progression among middle-aged blacks. These differences do not appear to be attributable to selective attrition or higher IMT among blacks at baseline.
Ranjit
Nalini
N
Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, MI, USA. nranjit@umich.edu
Diez-Roux
Ana V
AV
Chambless
Lloyd
L
Jacobs
David R
DR
Nieto
F Javier
FJ
Szklo
Moyses
M
D044383:Black People / Q000706:statistics & numerical data*; D002339:Carotid Arteries / Q000473:pathology; D002340:Carotid Artery Diseases / Q000191:economics / Q000208:ethnology* / Q000473:pathology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012923:Social Class; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology; D044465:White People / Q000706:statistics & numerical data*