Age and sex differences in the effect of parental stroke on the progression of carotid intima-media thickness.
OBJECTIVE
Parental stroke is a risk factor for stroke among the offspring. Carotid artery intima-media thickness (IMT) is a widely regarded surrogate marker for atherosclerosis and a predictive marker for stroke. This study examines whether parental stroke is associated with IMT progression.


METHODS
This longitudinal study had two measures of IMT that were taken upon enrollment of the 521 subjects and after an average follow-up of 4.1 years. The rate of IMT progression was tested for associations with parental stroke and cardiovascular risk factors using ANCOVA models. Age and sex were also tested as effect modifiers. The subjects were allocated into the young or old group using the age of 55 years.


RESULTS
Parental history of stroke was significantly associated with progression of common carotid artery (CCA) IMT compared with no parental stroke history (13.52 vs. 10.43 μm/year, adjusted p = 0.035). The parental effect on IMT progression of the bifurcation and internal carotid artery was dependent on age group. Young subjects had faster progression, whereas older subjects with parental stroke had slower progression. There was a three-way interaction among sex, age, and parental stroke in CCA IMT progression, such that young women with parental stroke had a 69.7% faster progression than young women without parental stroke (15.58 vs. 9.18 μm/year). However, this difference was not found in young men or old subjects with and without parental stroke.


CONCLUSIONS
Parental stroke is associated with carotid artery IMT progression and is more obvious in the young, especially among women. The results emphasize the clinical significance of parental stroke risk on atherosclerosis in young women.
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Hsiu-Fen
HF
Lin
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ling-Chun
LC
Huang
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, Kaohsiung Municipal Hsiaokang Hospital, Kaohsiung, Taiwan.
Chun-Hung
CH
Chen
Institute of Clinical Medicine, China Medical University, Taichung, Taiwan; Department of Neurology, China Medical University Hospital, Taichung, Taiwan.
Chung Y
CY
Hsu
Department of Neurology, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Neurology, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
Ruey-Tay
RT
Lin
Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan; Department of Medical Genetics, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan. Electronic address: hjuo@kmu.edu.tw.
Suh-Hang Hank
SH
Juo
D000328:Adult; D000367:Age Factors; D044466:Asian People / Q000235:genetics; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000208:ethnology / Q000235:genetics*; D059168:Carotid Intima-Media Thickness; D002681:China / Q000208:ethnology; D018450:Disease Progression; D005260:Female; D020022:Genetic Predisposition to Disease; D040941:Heredity; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010375:Pedigree; D010641:Phenotype; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012737:Sex Factors; D020521:Stroke / Q000175:diagnosis / Q000208:ethnology / Q000235:genetics*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors
Carotid intima-media thickness progression; Interaction; Parental stroke