Normative values and correlates of carotid artery intima-media thickness and carotid atherosclerosis in Andean-Hispanics: The Prevencion Study.
OBJECTIVE
Carotid intima-media thickness (cIMT) is an independent predictor of cardiovascular risk. Furthermore, ethnicity and gender-specific normative data are required to assess cIMT, which are not available for Andean-Hispanics. In addition, data regarding correlates of subclinical atherosclerosis in ethnic population are needed.


METHODS
We studied 1448 adults enrolled in a population-based study in Peru. cIMT and carotid plaque were measured with high-resolution ultrasonography. A healthy reference sample (n=472) with no cardiovascular disease, normal weight and normal metabolic parameters was selected to establish normative cIMT values. Correlates of abnormal cIMT and carotid plaque were assessed in the entire population.


RESULTS
In the reference sample, 95th-percentile cIMT values were both age and gender-dependent. In stepwise regression, selected predictors of increasing cIMT were: older age, impaired fasting glucose, diabetes mellitus, higher systolic blood pressure, higher LDL-cholesterol, smoking and male gender. Predictors of carotid plaque included older age, male gender, higher systolic blood pressure, lower diastolic blood pressure and higher LDL-cholesterol. HDL-cholesterol and C-reactive protein were not associated with cIMT or carotid plaque. The lack of association with HDL-cholesterol was confirmed using high performance liquid chromatography.


CONCLUSIONS
We present ethnic-specific cut-offs for abnormal cIMT applicable to Andean-Hispanics and correlates of subclinical atherosclerosis in this population. Pending longitudinal studies, our data supports several risk associations seen in other populations and can be used to identify Andean-Hispanics at increased risk for atherosclerotic cardiovascular disease. The lack of association between HDL-C and cIMT or carotid plaque in this population requires further investigation.
Pastorius
Catherine A
CA
Santa Maria Catholic University/Santa Maria Research Institute, Arequipa, Peru.
Medina-Lezama
Josefina
J
Corrales-Medina
Fernando
F
Bernabé-Ortiz
Antonio
A
Paz-Manrique
Roberto
R
Salinas-Najarro
Belissa
B
Khan
Zubair A
ZA
Takahashi
Junichiro
J
Toshima
Gen
G
Zea-Diaz
Humberto
H
Postigo-Macdowall
Mauricio
M
Chirinos-Pacheco
Julio
J
Ibañez
Francisco
F
Chirinos
Diana A
DA
Saif
Hassam
H
Chirinos
Julio A
JA
D050197:Atherosclerosis; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D008076:Cholesterol, HDL / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010568:Peru; D012016:Reference Values; D012044:Regression Analysis; D012306:Risk; D017539:Tunica Intima / Q000473:pathology*; D017540:Tunica Media / Q000473:pathology*
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL