title: Socioeconomic differences in progression of carotid intima-media thickness in the Atherosclerosis Risk in Communities study.
abstract: 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.
authors.affiliation: Center for Social Epidemiology and Population Health, School of Public Health, University of Michigan, MI, USA. nranjit@umich.edu
authors.forename: Nalini
authors.initials: N
authors.lastname: Ranjit
authors.forename: Ana V
authors.initials: AV
authors.lastname: Diez-Roux
authors.forename: Lloyd
authors.initials: L
authors.lastname: Chambless
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: F Javier
authors.initials: FJ
authors.lastname: Nieto
authors.forename: Moyses
authors.initials: M
authors.lastname: Szklo
mesh_terms: 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*