title: Carotid intima-media thickness is greater but carotid plaque prevalence is lower in black compared with white subjects.
abstract: OBJECTIVE
  Carotid IMT is widely used as a surrogate marker for atherosclerosis. Prospective studies in largely white populations demonstrate that it is strongly associated with carotid plaque and is an independent predictor of stroke. There are few data from black populations. In a previous study, we showed that carotid IMT is increased in black individuals in the UK. The purpose of this study was to confirm this with a larger sample size and to establish whether raised IMT in black stroke-free individuals is associated with increased carotid plaque.
  
  
  METHODS
  High-resolution sonography was used to measure the CCA-, BIF-, and ICA-IMT and plaque in 306 black and 281 white healthy individuals recruited by random community sampling from London, U.K. Mean CCA-IMT was determined by using a semiautomated computer program that detects the blood/intima borderline and the media/adventitia borderline with the use of a gray-value algorithm.
  
  
  RESULTS
  CCA-IMT was higher in black compared with white individuals after controlling for cardiovascular risk factors and socioeconomic status (β = 0.050; 95%CI, 0.024-0.076; P < .001). BIF- and ICA-IMT were also increased in black subjects. In contrast, carotid plaque was more common in white individuals (OR, 2.90; 95%CI, 1.41-5.96; P = .004).
  
  
  CONCLUSIONS
  The lack of correlation between increased IMT and carotid plaque in black individuals implies that IMT should not currently be used as a surrogate marker of atherosclerosis in black populations. It suggests that the increased IMT seen in black individuals may not represent early atherosclerosis.
authors.affiliation: St. George's University of London, United Kingdom.
authors.forename: A D
authors.initials: AD
authors.lastname: Mackinnon
authors.forename: P
authors.initials: P
authors.lastname: Jerrard-Dunne
authors.forename: L
authors.initials: L
authors.lastname: Porteous
authors.forename: H S
authors.initials: HS
authors.lastname: Markus
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People / Q000706:statistics & numerical data*; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000208:ethnology; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000208:ethnology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D020521:Stroke / Q000208:ethnology; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography; D044465:White People / Q000706:statistics & numerical data*