title: Predictors of carotid thickness and plaque progression during a decade: the Multi-Ethnic Study of Atherosclerosis.
abstract: OBJECTIVE
  Carotid artery intima-media thickness (IMT) and plaque are noninvasive markers of subclinical arterial injury that predict incident cardiovascular disease. We evaluated predictors of longitudinal changes in IMT and new plaque during a decade in a longitudinal multiethnic cohort.
  
  
  METHODS
  Carotid IMT and plaque were evaluated in Multi-Ethnic Study of Atherosclerosis (MESA) participants at exams 1 and 5, a mean (standard deviation) of 9.4 (0.5) years later. Far wall carotid IMT was measured in both common and internal carotid arteries. A plaque score was calculated from all carotid segments. Mixed-effects longitudinal and multivariate regression models evaluated associations of baseline risk factors and time-updated medication use with IMT progression and plaque formation.
  
  
  RESULTS
  The 3441 MESA participants were aged 60.3 (9.4) years (53% women; 26% blacks, 22% Hispanic, 13% Chinese); 1620 (47%) had carotid plaque. Mean common carotid artery IMT progression was 11.8 (12.8) μm/year, and 1923 (56%) subjects developed new plaque. IMT progressed more slowly in Chinese (β=-2.89; P=0.001) and Hispanic participants (β=-1.81; P=0.02), and with higher baseline high-density lipoprotein cholesterol (per 5 mg/dL; β=-0.22; P=0.03), antihypertensive use (β=-2.06; P=0.0004), and time on antihypertensive medications (years; β=-0.29; P<0.0001). Traditional risk factors were associated with new plaque formation, with strong associations for cigarette use (odds ratio, 2.31; P<0.0001) and protection by black ethnicity (odds ratio, 0.68; P<0.0001).
  
  
  CONCLUSIONS
  In a large, multiethnic cohort with a decade of follow-up, ethnicity was a strong, independent predictor of carotid IMT and plaque progression. Antihypertensive medication use was associated with less subclinical disease progression.
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Tattersall
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Amanda
authors.initials: A
authors.lastname: Gassett
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Claudia E
authors.initials: CE
authors.lastname: Korcarz
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Gepner
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Joel D
authors.initials: JD
authors.lastname: Kaufman
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Kiang J
authors.initials: KJ
authors.lastname: Liu
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Brad C
authors.initials: BC
authors.lastname: Astor
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Lianne
authors.initials: L
authors.lastname: Sheppard
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle.
authors.forename: Richard A
authors.initials: RA
authors.lastname: Kronmal
authors.affiliation: From the Department of Medicine, Division of Cardiovascular Medicine (M.C.T., C.E.K., A.D.G., J.H.S.), and Department of Medicine, Division of Nephrology (B.C.A.), University of Wisconsin School of Medicine and Public Health, Madison, WI; Department of Preventive Medicine Northwestern University Feinberg School of Medicine, Chicago, IL (K.J.L.); and Departments of Epidemiology (J.D.K.) and Biostatistics (A.G., L.S., R.A.K.), University of Washington School of Public Health, Seattle. jhs@medicine.wisc.edu.
authors.forename: James H
authors.initials: JH
authors.lastname: Stein
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000175:diagnosis* / Q000208:ethnology*; D059168:Carotid Intima-Media Thickness / Q000639:trends*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D018450:Disease Progression; D005006:Ethnicity / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic / Q000175:diagnosis* / Q000208:ethnology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors
keywords: atherosclerosis; carotid arteries; epidemiology; risk factors