title: Carotid Intima-media Thickness Measurements: Relations with Atherosclerosis, Risk of Cardiovascular Disease and Application in Randomized Controlled Trials.
abstract: Advances in the field of carotid ultrasound have been incremental, resulting in a steady decrease in measurement variability. Improvements in edge detection algorithms point toward increasing automation of CIMT measurements. The major advantage of CIMT is that it is completely noninvasive and can be repeated as often as required. It provides a continuous measure since all subjects have a measurable carotid wall. It is also relatively inexpensive to perform, and the technology is widely available. A graded relation between raising LDL cholesterol and increased CIMT is apparent. Increased CIMT has been shown consistently to relate the atherosclerotic abnormalities elsewhere in the arterial system. Moreover, increased CIMT predicts future vascular events in both populations from Caucasian ancestry and those from Asian ancestry. Furthermore, lipid‑lowering therapy has been shown to affect CIMT progression within 12–18 months in properly designed trials with results congruent with clinical events trials. In conclusion, when one wants to evaluate the effect of a pharmaceutical intervention that is to be expected to beneficially affect atherosclerosis progression and to reduce CV event risk, the use of CIMT measurements over time is a valid, suitable, and evidence‑based choice.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
authors.forename: Gregory W
authors.initials: GW
authors.lastname: Evans
authors.forename: Charles H
authors.initials: CH
authors.lastname: Tegeler
authors.forename: Rudy
authors.initials: R
authors.lastname: Meijer
mesh_terms: D050197:Atherosclerosis / Q000175:diagnosis*; D002318:Cardiovascular Diseases / Q000175:diagnosis; D059168:Carotid Intima-Media Thickness; D006801:Humans; D016032:Randomized Controlled Trials as Topic
references.citation: Lancet. 2007 Jul 14;370(9582):153-60
references.pmid: 17630038
references.citation: Diabetes Care. 2004 Dec;27(12):2887-92
references.pmid: 15562202
references.citation: Atherosclerosis. 1993 Aug;102(1):99-105
references.pmid: 8257458
references.citation: J Am Soc Echocardiogr. 2009 Oct;22(10):1137-44
references.pmid: 19801303
references.citation: Zhonghua Xin Xue Guan Bing Za Zhi. 2014 Mar;42(3):247-53
references.pmid: 24831484
references.citation: Heart. 2011 Aug;97(16):1326-31
references.pmid: 21653216
references.citation: Ann Intern Med. 2001 Dec 4;135(11):939-53
references.pmid: 11730394
references.citation: Stroke. 1994 Sep;25(9):1812-9
references.pmid: 8073462
references.citation: Ultrasound Med Biol. 1991;17(3):225-30
references.pmid: 1887507
references.citation: Arterioscler Thromb. 1994 Dec;14(12):1885-91
references.pmid: 7981175
references.citation: Ann Med. 2008;40(1):21-44
references.pmid: 17934910
references.citation: Int Angiol. 1997 Mar;16(1):50-4
references.pmid: 9165359
references.citation: Arterioscler Thromb. 1991 Sep-Oct;11(5):1245-9
references.pmid: 1911709
references.citation: Am J Epidemiol. 2002 Jan 1;155(1):38-47
references.pmid: 11772783
references.citation: J Hypertens. 2011 Nov;29(11):2181-93
references.pmid: 21918474
references.citation: Circulation. 1995 Oct 1;92(7):1758-64
references.pmid: 7671358
references.citation: J Am Coll Cardiol. 2000 Aug;36(2):438-43
references.pmid: 10933355
references.citation: Can J Cardiol. 2014 Dec;30(12):1620-6
references.pmid: 25442460
references.citation: Circulation. 2002 Oct 15;106(16):2055-60
references.pmid: 12379573
references.citation: Circulation. 2001 Apr 3;103(13):1721-6
references.pmid: 11282901
references.citation: Lancet. 2012 Jun 2;379(9831):2053-62
references.pmid: 22541275
references.citation: J Hypertens. 2011 Jun;29(6):1145-54
references.pmid: 21546878
references.citation: Lancet. 1993 May 15;341(8855):1232-7
references.pmid: 8098390
references.citation: Circulation. 2002 Sep 17;106(12):1453-9
references.pmid: 12234947
references.citation: Vasc Health Risk Manag. 2009;5:811-7
references.pmid: 19812693
references.citation: J Intern Med. 2007 Mar;261(3):293-305
references.pmid: 17305652
references.citation: Atherosclerosis. 2008 Mar;197(1):339-45
references.pmid: 17727858
references.citation: Arterioscler Thromb. 1993 Jan;13(1):64-9
references.pmid: 8422340
references.citation: J Intern Med. 2012 Mar;271(3):247-56
references.pmid: 21726301
references.citation: Lancet. 2011 Jul 2;378(9785):31-40
references.pmid: 21705069
references.citation: J Atheroscler Thromb. 2010 May;17(5):526-35
references.pmid: 20228610
references.citation: Stroke. 1990 Nov;21(11):1567-72
references.pmid: 2237950
references.citation: N Engl J Med. 1999 Jan 7;340(1):14-22
references.pmid: 9878640
references.citation: Stroke. 2004 Dec;35(12):2902-9
references.pmid: 15514180
references.citation: Am J Epidemiol. 1997 Sep 15;146(6):483-94
references.pmid: 9290509
references.citation: J Ultrasound Med. 2005 Apr;24(4):469-74
references.pmid: 15784765
references.citation: Circulation. 2005 May 17;111(19):2525-31
references.pmid: 15883215
references.citation: Arch Intern Med. 2003 Aug 11-25;163(15):1787-92
references.pmid: 12912713
references.citation: J Am Coll Cardiol. 1998 Jun;31(7):1561-7
references.pmid: 9626835
references.citation: J Stroke. 2013 Jan;15(1):38-48
references.pmid: 24324938
references.citation: Stat Med. 1989 Apr;8(4):431-40
references.pmid: 2727467
references.citation: Stroke. 1992 Dec;23(12):1705-11
references.pmid: 1448818
references.citation: J Am Coll Cardiol. 2012 Oct 16;60(16):1489-99
references.pmid: 22999719
references.citation: Neth J Med. 2002 Oct;60(9):354-61
references.pmid: 12572707
references.citation: Eur Heart J. 1994 Jun;15(6):781-5
references.pmid: 8088266
references.citation: Clin Ther. 2002 Jul;24(7):1175-93
references.pmid: 12182261
references.citation: J Intern Med. 1994 May;235(5):431-3
references.pmid: 8182398
references.citation: Circulation. 1986 Dec;74(6):1399-406
references.pmid: 3536154
references.citation: Am J Med. 1996 Dec;101(6):627-34
references.pmid: 9003110
references.citation: Am Heart J. 2011 Jun;161(6):1186-1191.e1
references.pmid: 21641367
references.citation: JAMA. 1996 Sep 11;276(10):785-91
references.pmid: 8769587
references.citation: Circulation. 2000 Sep 26;102(13):1503-10
references.pmid: 11004140
references.citation: J Am Coll Cardiol. 2008 Dec 16;52(25):2190-7
references.pmid: 19095138
references.citation: N Engl J Med. 2003 Aug 7;349(6):523-34
references.pmid: 12904517
references.citation: J Atheroscler Thromb. 2009 Aug;16(4):339-45
references.pmid: 19672031
references.citation: Menopause. 2007 Sep-Oct;14(5):879-84
references.pmid: 17667145
references.citation: Stroke. 1991 Sep;22(9):1155-63
references.pmid: 1926258
references.citation: Ann Intern Med. 1996 Mar 15;124(6):548-56
references.pmid: 8597317
references.citation: Arterioscler Thromb Vasc Biol. 1999 Nov;19(11):2795-800
references.pmid: 10559028
references.citation: Indian Heart J. 2005 Nov-Dec;57(6):675-80
references.pmid: 16521637
references.citation: Stroke. 1992 May;23(5):693-6
references.pmid: 1579968
references.citation: Circulation. 2001 Jun 19;103(24):2949-54
references.pmid: 11413085
references.citation: Ann Neurol. 2007 May;61(5):403-10
references.pmid: 17328068
references.citation: Atherosclerosis. 2005 Feb;178(2):387-97
references.pmid: 15694949
references.citation: Stroke. 1994 Aug;25(8):1581-7
references.pmid: 8042207
references.citation: Stroke. 2002 Feb;33(2):572-7
references.pmid: 11823672
references.citation: Arterioscler Thromb. 1993 Apr;13(4):482-6
references.pmid: 8466883
references.citation: Stroke. 1997 Mar;28(3):665-71
references.pmid: 9056629
references.citation: Stroke. 2014 Nov;45(11):3257-62
references.pmid: 25213342
references.citation: Arterioscler Thromb Vasc Biol. 2002 Oct 1;22(10):1692-7
references.pmid: 12377751
references.citation: Eur Heart J. 2006 Mar;27(6):746-55
references.pmid: 16415304
references.citation: JACC Cardiovasc Imaging. 2013 Nov;6(11):1160-7
references.pmid: 24229768
references.citation: Circulation. 1994 Oct;90(4):1679-87
references.pmid: 7734010
references.citation: Stroke. 2011 May;42(5):1338-44
references.pmid: 21415400
references.citation: J Atheroscler Thromb. 2013;20(1):108-21
references.pmid: 23095240
references.citation: J Am Coll Cardiol. 2010 Dec 7;56(24):2006-20
references.pmid: 21126642
references.citation: Heart. 2009 Nov;95(22):1826-35
references.pmid: 19632982
references.citation: J Am Soc Echocardiogr. 2012 Oct;25(10):1135-7
references.pmid: 22948017
references.citation: Curr Med Res Opin. 2012 May;28(5):681-8
references.pmid: 22439736
references.citation: J Hypertens. 2012 Sep;30(9):1690-6
references.pmid: 22895014
references.citation: Arterioscler Thromb. 1994 Feb;14(2):261-4
references.pmid: 8305418
references.citation: Stroke. 2009 Mar;40(3):730-6
references.pmid: 19118243
references.citation: J Clin Epidemiol. 2012 Jun;65(6):686-95
references.pmid: 22459429
references.citation: Control Clin Trials. 2003 Dec;24(6):752-75
references.pmid: 14662281
references.citation: J Am Coll Cardiol. 1989 Oct;14(4):947-52
references.pmid: 2677088
references.citation: J Am Soc Echocardiogr. 2012 Oct;25(10):1128-30
references.pmid: 22998794
references.citation: Stroke. 1997 Sep;28(9):1710-6
references.pmid: 9303013
references.citation: Arterioscler Thromb Vasc Biol. 2008 Dec;28(12):2296-302
references.pmid: 19020316
references.citation: J Hypertens. 1996 Jun;14(6):759-64
references.pmid: 8793699
references.citation: Circulation. 2002 Mar 5;105(9):1135-43
references.pmid: 11877368
references.citation: Stroke. 1999 Apr;30(4):841-50
references.pmid: 10187889
references.citation: JAMA. 2012 Aug 22;308(8):796-803
references.pmid: 22910757
references.citation: J Am Coll Cardiol. 2009 Jun 2;53(22):2028-35
references.pmid: 19477351
references.citation: Circulation. 1997 Sep 2;96(5):1432-7
references.pmid: 9315528
references.citation: Stroke. 1997 Feb;28(2):348-53
references.pmid: 9040688
references.citation: Clin Physiol. 1991 Nov;11(6):565-77
references.pmid: 1769190
references.citation: Atherosclerosis. 1996 Nov 15;127(1):103-12
references.pmid: 9006810
references.citation: Curr Med Res Opin. 2007 Apr;23(4):885-94
references.pmid: 17407645
references.citation: Stroke. 1992 Aug;23(8):1062-8
references.pmid: 1636178
references.citation: JAMA. 1992 Sep 9;268(10):1287-91
references.pmid: 1387172
references.citation: PLoS One. 2014;9(1):e85927
references.pmid: 24465793
references.citation: J Intern Med. 1991 Mar;229(3):225-31
references.pmid: 2007840
references.citation: Circulation. 1998 May 12;97(18):1784-90
references.pmid: 9603532
references.citation: Am Heart J. 2008 Apr;155(4):712-7
references.pmid: 18371481
references.citation: Ann Med. 2010 Sep;42(6):447-64
references.pmid: 20645885
references.citation: JAMA. 2009 Mar 18;301(11):1131-9
references.pmid: 19293413
references.citation: Stroke. 2014 Sep;45(9):2702-9
references.pmid: 25116876
references.citation: Circulation. 2007 Jan 30;115(4):459-67
references.pmid: 17242284
references.citation: Am Heart J. 2010 May;159(5):730-736.e2
references.pmid: 20435179
references.citation: Circulation. 2004 Dec 7;110(23):3512-7
references.pmid: 15537681
references.citation: JAMA. 2007 Mar 28;297(12):1344-53
references.pmid: 17384434
references.citation: Am J Epidemiol. 1991 Aug 1;134(3):250-6
references.pmid: 1877584
references.citation: Eur Heart J. 2007 Feb;28(4):398-406
references.pmid: 17277033
references.citation: Cerebrovasc Dis. 2010;30(2):180-7
references.pmid: 20588013
references.citation: Radiology. 1993 Aug;188(2):363-70
references.pmid: 8327679
references.citation: Lancet. 2001 Feb 24;357(9256):577-81
references.pmid: 11558482
references.citation: Arterioscler Thromb. 1991 Jul-Aug;11(4):966-72
references.pmid: 2065047
references.citation: Cerebrovasc Dis. 2012;34(4):290-6
references.pmid: 23128470
references.citation: JAMA. 2008 Apr 9;299(14):1678-89
references.pmid: 18398080
references.citation: Heart. 2011 Jul;97(14):1143-50
references.pmid: 21610270
references.citation: Ann Epidemiol. 1996 Mar;6(2):147-53
references.pmid: 8775595
references.citation: Eur Heart J. 2010 Jul;31(14):1682-9
references.pmid: 20542989
references.citation: Circulation. 2002 Nov 5;106(19):2422-7
references.pmid: 12417537
references.citation: Stroke. 2003 Dec;34(12):2985-94
references.pmid: 14615619
references.citation: J Am Coll Cardiol. 2012 Oct 23;60(17):1599-604
references.pmid: 22999720
references.citation: Eur J Epidemiol. 2003;18(7):715-27
references.pmid: 12952149
references.citation: Circ Cardiovasc Imaging. 2013 Jan 1;6(1):20-5
references.pmid: 23204038
references.citation: Circulation. 2001 Feb 20;103(7):919-25
references.pmid: 11181464
references.citation: J Am Soc Echocardiogr. 2008 Feb;21(2):93-111; quiz 189-90
references.pmid: 18261694
references.citation: Am J Cardiovasc Drugs. 2011 Aug 1;11(4):253-63
references.pmid: 21657803
references.citation: Fundam Clin Pharmacol. 2011 Aug;25(4):411-3
references.pmid: 20698890
references.citation: Lancet. 2011 Feb 12;377(9765):557-67
references.pmid: 21295846
references.citation: Am Heart J. 2010 Oct;160(4):701-14
references.pmid: 20934565
references.citation: J Am Soc Echocardiogr. 2012 Jan;25(1):91-100
references.pmid: 21982737
references.citation: Stroke. 2007 Jun;38(6):1774-9
references.pmid: 17446427
references.citation: Am J Clin Nutr. 2011 May;93(5):941-9
references.pmid: 21430116
references.citation: Stroke. 2004 Dec;35(12):2788-94
references.pmid: 15528460
references.citation: Stroke. 2004 Dec;35(12):2807-12
references.pmid: 15514192
references.citation: Curr Med Res Opin. 2007 Mar;23(3):641-8
references.pmid: 17355745
references.citation: Diabetologia. 2013 Jul;56(7):1494-502
references.pmid: 23568273
references.citation: Diabetes Res Clin Pract. 2013 Sep;101(3):286-92
references.pmid: 23835494
references.citation: N Engl J Med. 2007 Apr 19;356(16):1620-30
references.pmid: 17387131
references.citation: N Engl J Med. 2008 Apr 3;358(14):1431-43
references.pmid: 18376000
references.citation: J Hypertens. 1996 Dec;14(12):1441-6
references.pmid: 8986927
references.citation: Int J Cardiol. 2013 Oct 3;168(3):2761-6
references.pmid: 23618432
references.citation: Atherosclerosis. 1993 Sep;102(2):163-73
references.pmid: 8251002
references.citation: Clin Sci (Lond). 2001 Nov;101(5):455-64
references.pmid: 11672450
references.citation: Curr Control Trials Cardiovasc Med. 2005 Mar 10;6(1):3
references.pmid: 15760471
references.citation: Curr Med Res Opin. 2009 Jan;25(1):109-22
references.pmid: 19210144
references.citation: Eur Heart J. 2007 Sep;28(17):2094-101
references.pmid: 17597051
references.citation: Eur J Prev Cardiol. 2012 Aug;19(4):687-97
references.pmid: 21613319
references.citation: Curr Med Res Opin. 2012 Jun;28(6):891-9
references.pmid: 22536884
references.citation: Am J Cardiol. 1995 Mar 1;75(7):455-9
references.pmid: 7863988
references.citation: J Clin Epidemiol. 1994 Aug;47(8):921-30
references.pmid: 7730896
references.citation: Stroke. 1992 Dec;23(12):1752-60
references.pmid: 1448826
references.citation: Pharmacol Rev. 2007 Mar;59(1):40-53
references.pmid: 17329547
references.citation: Nat Rev Cardiol. 2011 Mar;8(3):128-30
references.pmid: 21350577
references.citation: Ann Intern Med. 1998 Feb 15;128(4):262-9
references.pmid: 9471928
references.citation: Hypertension. 2009 Nov;54(5):919-50
references.pmid: 19729599
references.citation: Eur J Cardiovasc Prev Rehabil. 2006 Jun;13(3):341-7
references.pmid: 16926662
references.citation: J Am Coll Cardiol. 2006 Mar 21;47(6):1108-16
references.pmid: 16545638