Cardiovascular risk profile of asymptomatic healthy young adults with increased carotid artery intima-media thickness: the Bogalusa Heart Study.

ABSTRACT

OBJECTIVE: The cardiovascular (CV) risk profile of healthy young adults was studied at the extreme 5th percentiles of carotid intima-medial thickness (IMT) as measured by B-mode ultrasonography in different segments of the carotid artery. METHODS: Anthropometric variables, blood pressure, laboratory data, family history health habits were collected from 518 individuals (mean age 32 years). Individuals in the top and bottom 5th percentiles of IMT of carotid bulb or bifurcation area (n = 22) and the common carotid (n = 25) segments were examined for presence of risk factors. Univariate analyses compared the two groups, t tests, and chi-square tests were performed. RESULTS: The common carotid segment top and bottom percentiles of IMT differed with respect to age (p < 0.000), BMI (p < 0.001). In contrast, carotid bulb segment top and bottom percentiles differed with respect to age, (p = 0.001), BMI (p = 0.004), HDL cholesterol (p 0.006), LDL cholesterol (p = 0.023), ECG diagnosis (p = 0.016), smoking status (p = 0.004). The individuals in the top 5th percentile of IMT of the bifurcation area were more obese (BMI > 30), hypertensive (BP > 140/90 or on medications), dyslipidemic (LDL > 130 mg/dl, triglycerides > 150, HDL < 40 mg/dl), and more often had an abnormal ECG, and a history of smoking. CONCLUSION: The observed deleterious effect of CV risk factors on IMT of the carotid artery, a surrogate measure of coronary atherosclerosis, underscores the risk factor profile history in youth. The prevalence of multiple risk factors among those in the top 5th percentile of IMT was significantly higher with respect to the carotid bulb segment only (p = 0.000), suggesting more sensitivity to the risk factor burden compared with the common carotid segment. These observations have important implications in preventive cardiology.