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American Journal of Epidemiology Vol. 134, No. 3: 250-256
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health


research-article

Carotid Atherosclerosis Measured by B-Mode Ultrasound in Populations: Associations with Cardiovascular Risk Factors in the ARIC Study

Gerardo Heiss1,, A. Richey Sharrett2, Ralph Barnes3, L. E. Chambless4, Moyses Szklo5, Carlos Alzola4 and the ARIC Investigators

1Department of Epidemiology, University of North Carolina School of Public Health Chapel Hill, NC.
2Division of Epidemiology and Clinical Applications, National Heart, Lung, and Blood Institute Bethesda, MD.
3ARIC Ultrasound Reading Center Winston-Salem, NC.
4Department of Biostatstics, University of North Carolina School of Public Health Chapel Hill, NC.
5Department of Epidemiology, The Johns Hopkins School of Hygiene and Public Health Baltimore, MD.

Reprint requests to Dr. Gerardo Heiss, Department of Epidemiology, CB#7400, McGavran-Greenberg Hall, The University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7400

To assess whether carotid atherosclerosis measured by B-mode ultrasound is related to cardiovascular risk factors, 386 cases with carotid artery wall thickening and an equal number of controls free of arterial intima-media thickening were drawn from the cohort of the Atherosclerosis Risk in Communities (ARIC) Study examined in four communities in the United States between 1988 and 1990. Cases and controls were individually matched on sex, race, age group, study center, and date of examination. The mean values of total cholesterol, low density lipoprotein (LDL) cholesterol, total triglyceride, blood pressure, and pack-years of cigarette smoking were higher in cases than controls. Mean high density lipoprotein (HDL) cholesterol was lower in cases than controls. Case-control differences were all statistically significant. Multivariable-adjusted odds ratios point to differences of considerable magnitude in the risk of carotid atherosclerosis between groups defined by clinical and public health-oriented risk factor cut-points. Am J Epidemiol 1991;134:250–6.

arteriosclerosis; cardiovascular diseases; hypertension; lipoproteins; smoking; ultrasonics


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J Am Coll CardiolHome page
L. Belhassen, C. Carville, G. Pelle, J. L. Monin, E. Teiger, A.-M. Duval-Moulin, P. Dupouy, J. L. Dubois Rande, and P. Gueret
Evaluation of carotid artery and aortic intima-media thickness measurements for exclusion of significant coronary atherosclerosis in patients scheduled for heart valve surgery
J. Am. Coll. Cardiol., April 3, 2002; 39(7): 1139 - 1144.
[Abstract] [Full Text] [PDF]


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LupusHome page
P R J Ames, A Margarita, J D. Alves, C Tommasino, L Iannaccone, and V Brancaccio
Anticardiolipin antibody titre and plasma homocysteine level independently predict intima media thickness of carotid arteries in subjects with idiopathic antiphospholipid antibodies
Lupus, April 1, 2002; 11(4): 208 - 214.
[Abstract] [PDF]


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Am J EpidemiolHome page
L. E. Chambless, A. R. Folsom, V. Davis, R. Sharrett, G. Heiss, P. Sorlie, M. Szklo, G. Howard, and G. W. Evans
Risk Factors for Progression of Common Carotid Atherosclerosis: The Atherosclerosis Risk in Communities Study, 1987-1998
Am. J. Epidemiol., January 1, 2002; 155(1): 38 - 47.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. H. Davis, J. D. Dawson, W. A. Riley, and R. M. Lauer
Carotid Intimal-Medial Thickness Is Related to Cardiovascular Risk Factors Measured From Childhood Through Middle Age: The Muscatine Study
Circulation, December 4, 2001; 104(23): 2815 - 2819.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
B. M. McQuillan, J. Hung, J. P. Beilby, M. Nidorf, and P. L. Thompson
Antioxidant vitamins and the risk of carotid atherosclerosis: The perth carotid ultrasound disease assessment study (CUDAS)
J. Am. Coll. Cardiol., December 1, 2001; 38(7): 1788 - 1794.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Blackburn, P. Giral, E. Bruckert, J.-M. Andre, S. Gonbert, M. Bernard, M. J. Chapman, and G. Turpin
Elevated C-Reactive Protein Constitutes an Independent Predictor of Advanced Carotid Plaques in Dyslipidemic Subjects
Arterioscler Thromb Vasc Biol, December 1, 2001; 21(12): 1962 - 1968.
[Abstract] [Full Text] [PDF]


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StrokeHome page
P. Rubba, S. Panico, M. G. Bond, G. Covetti, E. Celentano, A. Iannuzzi, R. Galasso, M. A. Belisario, A. Pastinese, L. Sacchetti, et al.
Site-Specific Atherosclerotic Plaques in the Carotid Arteries of Middle-Aged Women From Southern Italy: Associations With Traditional Risk Factors and Oxidation Markers
Stroke, September 1, 2001; 32(9): 1953 - 1959.
[Abstract] [Full Text] [PDF]


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CirculationHome page
A. Sramek, J.H.C. Reiber, W.B.J. Gerrits, and F.R. Rosendaal
Decreased Coagulability Has No Clinically Relevant Effect on Atherogenesis: Observations in Individuals With a Hereditary Bleeding Tendency
Circulation, August 14, 2001; 104(7): 762 - 767.
[Abstract] [Full Text] [PDF]


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JAMAHome page
R. L. Sacco, R. T. Benson, D. E. Kargman, B. Boden-Albala, C. Tuck, I-F. Lin, J. F. Cheng, M. C. Paik, S. Shea, and L. Berglund
High-Density Lipoprotein Cholesterol and Ischemic Stroke in the Elderly: The Northern Manhattan Stroke Study
JAMA, June 6, 2001; 285(21): 2729 - 2735.
[Abstract] [Full Text] [PDF]


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Vasc MedHome page
J Forsblad, A Gottsater, T Matzsch, and F Lindgarde
Predictors of carotid endarterectomy in middle-aged individuals
Vascular Medicine, May 1, 2001; 6(2): 81 - 85.
[Abstract] [PDF]


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CirculationHome page
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al.
Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association
Circulation, January 2, 2001; 103(1): 163 - 182.
[Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
H. Tanaka, F. A. Dinenno, K. D. Monahan, C. A. DeSouza, and D. R. Seals
Carotid Artery Wall Hypertrophy With Age Is Related to Local Systolic Blood Pressure in Healthy Men
Arterioscler Thromb Vasc Biol, January 1, 2001; 21(1): 82 - 87.
[Abstract] [Full Text] [PDF]


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StrokeHome page
L. B. Goldstein, R. Adams, K. Becker, C. D. Furberg, P. B. Gorelick, G. Hademenos, M. Hill, G. Howard, V. J. Howard, B. Jacobs, et al.
Primary Prevention of Ischemic Stroke : A Statement for Healthcare Professionals From the Stroke Council of the American Heart Association
Stroke, January 1, 2001; 32(1): 280 - 299.
[Full Text] [PDF]


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NEJMHome page
G. Gaeta, M. De Michele, S. Cuomo, P. Guarini, M. C. Foglia, M. G. Bond, and M. Trevisan
Arterial Abnormalities in the Offspring of Patients with Premature Myocardial Infarction
N. Engl. J. Med., September 21, 2000; 343(12): 840 - 846.
[Abstract] [Full Text] [PDF]


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NeurologyHome page
B. Guillon, C. Tzourio, V. Biousse, V. Adrai, M. G. Bousser, and P. J. Touboul
Arterial wall properties in carotid artery dissection: An ultrasound study
Neurology, September 12, 2000; 55(5): 663 - 666.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. Takiuchi, H. Rakugi, K. Honda, T. Masuyama, N. Hirata, H. Ito, K. Sugimoto, Y. Yanagitani, K. Moriguchi, A. Okamura, et al.
Quantitative Ultrasonic Tissue Characterization Can Identify High-Risk Atherosclerotic Alteration in Human Carotid Arteries
Circulation, August 15, 2000; 102(7): 766 - 770.
[Abstract] [Full Text] [PDF]


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Am. J. Clin. Nutr.Home page
P. M Ueland, H. Refsum, S. A. Beresford, and S. E. Vollset
The controversy over homocysteine and cardiovascular risk
Am. J. Clinical Nutrition, August 1, 2000; 72(2): 324 - 332.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. Zureik, P. Ducimetiere, P.-J. Touboul, D. Courbon, C. Bonithon-Kopp, C. Berr, and C. Magne
Common Carotid Intima-Media Thickness Predicts Occurrence of Carotid Atherosclerotic Plaques : Longitudinal Results From the Aging Vascular Study (EVA) Study
Arterioscler Thromb Vasc Biol, June 1, 2000; 20(6): 1622 - 1629.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
R. Klein, A. R. Sharrett, B. E. K. Klein, L. E. Chambless, L. S. Cooper, L. D. Hubbard, and G. Evans
Are Retinal Arteriolar Abnormalities Related to Atherosclerosis? : The Atherosclerosis Risk in Communities Study
Arterioscler Thromb Vasc Biol, June 1, 2000; 20(6): 1644 - 1650.
[Abstract] [Full Text] [PDF]


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LupusHome page
S Manzi, L H Kuller, D Edmundowicz, and K Sutton-Tyrrell
Vascular imaging: changing the face of cardiovascular research
Lupus, March 1, 2000; 9(3): 176 - 182.
[Abstract] [PDF]


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StrokeHome page
E. Stensland-Bugge, K. H. Bonaa, O. Joakimsen, and I. Njolstad
Sex Differences in the Relationship of Risk Factors to Subclinical Carotid Atherosclerosis Measured 15 Years Later : The Tromso Study
Stroke, March 1, 2000; 31(3): 574 - 581.
[Abstract] [Full Text] [PDF]


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J Am Coll CardiolHome page
C. J. Wiedermann, S. Kiechl, S. Dunzendorfer, P. Schratzberger, G. Egger, F. Oberhollenzer, and J. Willeit
Association of endotoxemia with carotid atherosclerosis and cardiovascular disease: Prospective results from the bruneck study
J. Am. Coll. Cardiol., December 1, 1999; 34(7): 1975 - 1981.
[Abstract] [Full Text] [PDF]


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CLIN APPL THROMB HEMOSTHome page
F. Bilora, C. Dei Rossi, B. Girolami, A. Casonato, E. Zanon, A. Bertomoro, and A. Girolami
Do Hemophilia A and von Willebrand Disease Protect Against Carotid Atherosclerosis? A Comparative Study Between . Coagulopathics and Normal Subjects by Means of Carotid Echo-Color Doppler Scan
Clinical and Applied Thrombosis/Hemostasis, October 1, 1999; 5(4): 232 - 235.
[Abstract] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. Skoglund-Andersson, R. Tang, M. G. Bond, U. de Faire, A. Hamsten, and F. Karpe
LDL Particle Size Distribution Is Associated With Carotid Intima-Media Thickness in Healthy 50-Year-Old Men
Arterioscler Thromb Vasc Biol, October 1, 1999; 19(10): 2422 - 2430.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
L. H. Kuller, K. A. Matthews, K. Sutton-Tyrrell, D. Edmundowicz, and C. H. Bunker
Coronary and Aortic Calcification Among Women 8 Years After Menopause and Their Premenopausal Risk Factors : The Healthy Women Study
Arterioscler Thromb Vasc Biol, September 1, 1999; 19(9): 2189 - 2198.
[Abstract] [Full Text] [PDF]


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Arch OphthalmolHome page
R. Klein, L. Clegg, L. S. Cooper, L. D. Hubbard, B. E. K. Klein, W. N. King, A. R. Folsom, and for the Atherosclerosis Risk in Communities Study
Prevalence of Age-related Maculopathy in the Atherosclerosis Risk in Communities Study
Arch Ophthalmol, September 1, 1999; 117(9): 1203 - 1210.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. C. G. Simons, A. Algra, M. L. Bots, D. E. Grobbee, and Y. van der Graaf
Common Carotid Intima-Media Thickness and Arterial Stiffness : Indicators of Cardiovascular Risk in High-Risk PatientsThe SMART Study (Second Manifestations of ARTerial disease)
Circulation, August 31, 1999; 100(9): 951 - 957.
[Abstract] [Full Text] [PDF]


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CirculationHome page
P. H. Davis, J. D. Dawson, L. T. Mahoney, and R. M. Lauer
Increased Carotid Intimal-Medial Thickness and Coronary Calcification Are Related in Young and Middle-Aged Adults : The Muscatine Study
Circulation, August 24, 1999; 100(8): 838 - 842.
[Abstract] [Full Text] [PDF]


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CirculationHome page
S. Boquist, G. Ruotolo, R. Tang, J. Bjorkegren, M. G. Bond, U. de Faire, F. Karpe, and A. Hamsten
Alimentary Lipemia, Postprandial Triglyceride-Rich Lipoproteins, and Common Carotid Intima-Media Thickness in Healthy, Middle-Aged Men
Circulation, August 17, 1999; 100(7): 723 - 728.
[Abstract] [Full Text] [PDF]


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StrokeHome page
A. Festa, R. D'Agostino Jr, P. Rautaharju, D. H. O'Leary, M. Rewers, L. Mykkanen, and S. M. Haffner
Is QT Interval a Marker of Subclinical Atherosclerosis in Nondiabetic Subjects? : The Insulin Resistance Atherosclerosis Study (IRAS)
Stroke, August 1, 1999; 30(8): 1566 - 1571.
[Abstract] [Full Text] [PDF]


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StrokeHome page
K. Jensen-Urstad, M. Jensen-Urstad, and J. Johansson
Carotid Artery Diameter Correlates With Risk Factors for Cardiovascular Disease in a Population of 55-Year-Old Subjects
Stroke, August 1, 1999; 30(8): 1572 - 1576.
[Abstract] [Full Text] [PDF]


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CirculationHome page
B. M. McQuillan, J. P. Beilby, M. Nidorf, P. L. Thompson, and J. Hung
Hyperhomocysteinemia but Not the C677T Mutation of Methylenetetrahydrofolate Reductase Is an Independent Risk Determinant of Carotid Wall Thickening : The Perth Carotid Ultrasound Disease Assessment Study (CUDAS)
Circulation, May 11, 1999; 99(18): 2383 - 2388.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
C. Thalhammer, B. Balzuweit, A. Busjahn, C. Walter, F. C. Luft, and H. Haller
Endothelial Cell Dysfunction and Arterial Wall Hypertrophy Are Associated With Disturbed Carbohydrate Metabolism in Patients at Risk for Cardiovascular Disease
Arterioscler Thromb Vasc Biol, May 1, 1999; 19(5): 1173 - 1179.
[Abstract] [Full Text] [PDF]


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StrokeHome page
S. Ebrahim, O. Papacosta, P. Whincup, G. Wannamethee, M. Walker, A. N. Nicolaides, S. Dhanjil, M. Griffin, G. Belcaro, A. Rumley, et al.
Carotid Plaque, Intima Media Thickness, Cardiovascular Risk Factors, and Prevalent Cardiovascular Disease in Men and Women : The British Regional Heart Study
Stroke, April 1, 1999; 30(4): 841 - 850.
[Abstract] [Full Text] [PDF]


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JAMAHome page
P. B. Gorelick, R. L. Sacco, D. B. Smith, M. Alberts, L. Mustone-Alexander, D. Rader, J. L. Ross, E. Raps, M. N. Ozer, L. M. Brass, et al.
Prevention of a First Stroke: A Review of Guidelines and a Multidisciplinary Consensus Statement From the National Stroke Association
JAMA, March 24, 1999; 281(12): 1112 - 1120.
[Abstract] [Full Text] [PDF]


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ANGIOLOGYHome page
P. Poredos, M. Orehek, E. Tratnik, and P. Poredos
Smoking is Associated with Dose-Related Increase of Intima-Media Thickness and Endothelial Dysfunction
Angiology, March 1, 1999; 50(3): 201 - 208.
[Abstract] [PDF]


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StrokeHome page
M. Zureik, P.-J. Touboul, C. Bonithon-Kopp, D. Courbon, C. Berr, C. Leroux, and P. Ducimetiere
Cross-Sectional and 4-Year Longitudinal Associations Between Brachial Pulse Pressure and Common Carotid Intima-Media Thickness in a General Population : The EVA Study
Stroke, March 1, 1999; 30(3): 550 - 555.
[Abstract] [Full Text] [PDF]


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Arterioscler. Thromb. Vasc. Bio.Home page
M. Zureik, P.-J. Touboul, C. Bonithon-Kopp, D. Courbon, I. Ruelland, and P. Ducimetiere
Differential Association of Common Carotid Intima-Media Thickness and Carotid Atherosclerotic Plaques With Parental History of Premature Death From Coronary Heart Disease : The EVA Study
Arterioscler Thromb Vasc Biol, February 1, 1999; 19(2): 366 - 371.
[Abstract] [Full Text] [PDF]



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