title: Carotid intima-media thickness in the Spanish population: reference ranges and association with cardiovascular risk factors.
abstract: OBJECTIVE
  Carotid intima-media thickness as measured with ultrasonography is an inexpensive and noninvasive predictor of cardiovascular events. The objectives of this study were to determine the population reference ranges of carotid intima-media thickness for individuals aged 35-84 years in Spain and to analyze the association of carotid intima-media thickness with cardiovascular risk factors (age, smoking, diabetes, pulse pressure, lipid profile, and body mass index).
  
  
  METHODS
  Population-based cross-sectional study conducted in Gerona (Spain). We described the mean and maximal values of carotid intima-media thickness of the carotid artery and of its 3 segments (common carotid, carotid bulb and internal carotid). We assessed cardiovascular risk factors and analyzed their association with carotid intima-media thickness using adjusted linear regression models.
  
  
  RESULTS
  A total of 3161 individuals (54% women) were included, with mean age 58 years. Men showed significantly higher mean common carotid intima-media thickness than did women (0.71 vs 0.67 mm). The strongest predictors of this measure were age (coefficients for 10-year increase: 0.65 and 0.58 for women and men, respectively), smoking in men (coefficient: 0.26), high-density lipoprotein cholesterol in women (coefficient for 10 mg/dL, increase: -0.08) and pulse pressure in both sexes (coefficients for 10 mmHg increase: 0.08 and 0.23 for women and men, respectively). The results were similar for the mean carotid intima-media thickness of all the segments.
  
  
  CONCLUSIONS
  This population-based study presents the reference ranges for carotid intima-media thickness in the Spanish population. The main determinants of carotid intima-media thickness were age and pulse pressure in both sexes.
authors.affiliation: Grup d'Epidemiologia i Genètica Cardiovascular, Programa de Recerca en Processos Inflammatoris i Cardiovasculars, IMIM-Institut Hospital del Mar d'Investigacions Mèdiques, Barcelona, España. mgrau@imim.es
authors.forename: Maria
authors.initials: M
authors.lastname: Grau
authors.forename: Isaac
authors.initials: I
authors.lastname: Subirana
authors.forename: David
authors.initials: D
authors.lastname: Agis
authors.forename: Rafel
authors.initials: R
authors.lastname: Ramos
authors.forename: Xavier
authors.initials: X
authors.lastname: Basagaña
authors.forename: Ruth
authors.initials: R
authors.lastname: Martí
authors.forename: Eric
authors.initials: E
authors.lastname: de Groot
authors.forename: Roman J
authors.initials: RJ
authors.lastname: Arnold
authors.forename: Jaume
authors.initials: J
authors.lastname: Marrugat
authors.forename: Nino
authors.initials: N
authors.lastname: Künzli
authors.forename: Roberto
authors.initials: R
authors.lastname: Elosua
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D008076:Cholesterol, HDL / Q000097:blood; D003327:Coronary Disease / Q000000981:diagnostic imaging / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D012042:Registries; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology
chemical_list: D008076:Cholesterol, HDL