title: Smoking status and common carotid artery intima-medial thickness among middle-aged men and women based on ultrasound measurement: a cohort study.
abstract: BACKGROUND
  Cigarette smoking is an established causal factor for atherosclerosis. However, the smoking effect on different echogenic components of carotid arterial wall measured by ultrasound is not well elucidated.
  
  
  METHODS
  Middle-aged men and women who had IMT measurement > or = 0.7 mm at baseline and follow-up were included (N = 413, age 40-60 years at baseline in 1995). Intima-media thickness of common carotid artery (CCA-IMT) and its components (echogenic and echolucent layers) were measured at baseline and in the follow-up examination 3 years later. IMT and its components were compared across current, former and never smokers. Individual growth models were used to examine how smoking status was related to the baseline and progression of overall IMT and IMT components.
  
  
  RESULTS
  For both men and women, current smoking was associated with thicker echogenic layer than never smokers; former smokers exhibited thinner echogenic layer than current smokers after adjustment for cigarette pack-years. Among women, current smoking was also associated with a thinned echolucent layer that resulted in a non-significant overall association of current smoking with IMT for women.
  
  
  CONCLUSIONS
  Cigarette smoking is associated with carotid artery morphological changes and the association is sex-dependent. The atherogenic effect of smoking appears to be partly reversible among former smokers. IMT measurement alone may not be adequate to detect carotid atherosclerosis associated with cigarette smoking among middle-age women.
authors.affiliation: Prevention Research Center, Pacific Institute for Research and Evaluation, Berkeley, CA, USA. afan@prev.org
authors.forename: Amy Z
authors.initials: AZ
authors.lastname: Fan
authors.forename: Maura
authors.initials: M
authors.lastname: Paul-Labrador
authors.forename: C Noel Bairey
authors.initials: CN
authors.lastname: Merz
authors.forename: Carlos
authors.initials: C
authors.lastname: Iribarren
authors.forename: James H
authors.initials: JH
authors.lastname: Dwyer
mesh_terms: D000328:Adult; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging* / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012907:Smoking / Q000453:epidemiology*; D017539:Tunica Intima / Q000000981:diagnostic imaging* / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging* / Q000473:pathology*; D014463:Ultrasonography