title: Sex differences in early carotid atherosclerosis (from the community-based Gutenberg-Heart Study).
abstract: The objectives of this study were to describe gender differences in intima-media thickness (IMT) in a community-based population study and to define normal IMT values for healthy men and women. In total, 4,814 participants (aged 35 to 74 years; 2,433 men, 2,381 women) from the Gutenberg-Heart Study (GHS) were included. IMT was measured at both common carotid arteries using an edge detection system. Median IMT was 0.62 mm (25th percentile 0.55, 75th percentile 0.70) in women and 0.65 mm (25th percentile 0.57, 75th percentile 0.75) in men and was significantly associated with age (p <0.0001). On multivariate analysis, advanced age, smoking, and arterial hypertension were positively associated with higher IMT in men and women. A subgroup of 1,025 subjects without cardiovascular risk factors or previous cardiovascular disease was analyzed to define normal IMT values. Nomograms were calculated according to age and gender. For each age group, IMT >95th percentile was defined as abnormal. In this subgroup, gender differences in IMT became nonsignificant at older ages. At the age of 35 years, IMT was 0.71 mm in men and 0.61 mm in women at the 95th percentile. In comparison, at the age of 74 years, IMT at the 95th percentile was 0.90 mm in men and 0.89 mm in women. In conclusion, men had higher carotid IMT than women, but predictors of early carotid atherosclerosis were similar across genders. In young subjects without cardiovascular risk factors, normal values for IMT were lower in women compared with men. In contrast, in older subjects, gender differences in IMT became nonsignificant.
authors.affiliation: Department of Medicine 2, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Sinning
authors.forename: Philip S
authors.initials: PS
authors.lastname: Wild
authors.forename: Francisco M Ojeda
authors.initials: FM
authors.lastname: Echevarria
authors.forename: Sandra
authors.initials: S
authors.lastname: Wilde
authors.forename: Renate
authors.initials: R
authors.lastname: Schnabel
authors.forename: Edith
authors.initials: E
authors.lastname: Lubos
authors.forename: Stephanie
authors.initials: S
authors.lastname: Herkenhoff
authors.forename: Christoph
authors.initials: C
authors.lastname: Bickel
authors.forename: Sven
authors.initials: S
authors.lastname: Klimpe
authors.forename: Tommaso
authors.initials: T
authors.lastname: Gori
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Münzel
authors.forename: Stefan
authors.initials: S
authors.lastname: Blankenberg
authors.forename: Christine
authors.initials: C
authors.lastname: Espinola-Klein
mesh_terms: D000328:Adult; D000368:Aged; D002340:Carotid Artery Diseases / Q000473:pathology*; D017536:Carotid Artery, Common / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012727:Sex Characteristics; D017539:Tunica Intima / Q000473:pathology; D017540:Tunica Media / Q000473:pathology