title: Sex-specific associations of cardiovascular risk factors with carotid stiffness--results from the SAPALDIA cohort study.
abstract: OBJECTIVE
  Manifestation of cardiovascular disease (CVD) occurs with clear sex differences. Carotid stiffness (CS) parameters are increasingly used for CVD risk assessment but the sex-specific association with CVD risk factors as well as association patterns between CS parameters are largely unknown, which we investigated in SAPALDIA population-based cohort participants.
  
  
  METHODS
  Risk factors of 2545 participants without clinically manifest disease were evaluated in 2001-2003 and different CS parameters were assessed in carotid ultrasound scans in 2010-2011. Stratified and non-stratified mixed linear models and multivariate regression analyses were used to examine sex-specific associations, differences and association patterns of single risk factors and CS parameters.
  
  
  RESULTS
  HDL cholesterol was the only significant protective determinant of reduced CS for both sexes (ranges of CS parameters: -3.7; -0.8% of changes in geometric mean per 1SD of the risk factor on an inverted scale) and significant adverse risk factors were BMI (-0.5; 4.7%), systolic (-1.23; 4.7%) and diastolic blood pressure (1.4; 4.4%), heart rate (2.7; 7.9%), C-reactive protein (0.6; 3.3%) and smoking (-2.82; 1%), all p-values of multivariate analyses were <0.01. Sex differences with stiffer CS parameters in men were observed for increased heart rate (p = 0.001) and LDL cholesterol (p < 0.001) and in women for triglyceride (p < 0.003). Similar association patterns were found for most CS parameters.
  
  
  CONCLUSIONS
  Sex-specific associations of cardiovascular risk factors may reflect a sex-specific burden of atherosclerotic risk factors and similar association patterns across different CS parameters within men and women may allow the use of CS parameters in an exchangeable manner.
authors: Department of Sport, Exercise and Health, Div. Sports and Exercise Medicine, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland. Electronic address: seraina.caviezel@unibas.ch.
authors: Seraina
authors: S
authors: Caviezel
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Julia
authors: J
authors: Dratva
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Emmanuel
authors: E
authors: Schaffner
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Christian
authors: C
authors: Schindler
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Elisabeth
authors: E
authors: Zemp Stutz
authors: Imagelabonline, Science Centre, Matrix II I-08 Kruisweg 400, 1095XH Amsterdam, The Netherlands; Department of Cardiology and Thoracic Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
authors: Eric
authors: E
authors: de Groot
authors: Hôpital Intercantonal de la Broye, Avenue de la Colline 3, 1530 Payerne, Switzerland.
authors: Luc
authors: L
authors: Burdet
authors: Zürcher Höhenklinik Davos, Klinikstrasse 6, 7272 Davos Clavadel, Switzerland.
authors: Thomas
authors: T
authors: Rothe
authors: Division of Pulmonary Medicine, Regional Hospital Lugano, Via Tesserete 46, 6900 Lugano, Switzerland.
authors: Marco
authors: M
authors: Pons
authors: Department of Community Medicine and Primary Care, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.
authors: Jean-Michel
authors: JM
authors: Gaspoz
authors: Division of Pulmonary Medicine, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil 4, 1211 Geneva, Switzerland.
authors: Thierry
authors: T
authors: Rochat
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Nino
authors: N
authors: Künzli
authors: Swiss Tropical and Public Health Institute, Socinstrasse 57, 4002 Basel, Switzerland; University of Basel, Petersplatz 1, 4003 Basel, Switzerland.
authors: Nicole
authors: N
authors: Probst-Hensch
authors: Department of Sport, Exercise and Health, Div. Sports and Exercise Medicine, University of Basel, Birsstrasse 320B, 4052 Basel, Switzerland.
authors: Arno
authors: A
authors: Schmidt-Trucksäss
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000209:etiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006339:Heart Rate; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012727:Sex Characteristics; D012907:Smoking / Q000009:adverse effects; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography; D059289:Vascular Stiffness
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D014280:Triglycerides
keywords: Arterial stiffness; Cardiovascular risk factors; Common carotid artery; Haemodynamic properties; Ultrasound