(Stroke. 1997;28:929-935.)
© 1997 American Heart Association, Inc.
Articles |
Race-Ethnicity and Determinants of Carotid Atherosclerosis in a Multiethnic Population
The Northern Manhattan Stroke Study
From the Department of Neurology (R.L.S., J.K.R., B.B.-A., Q.G., I.-F.L., D.E.K., W.A.H.); Sergievsky Center (R.L.S., J.K.R., W.A.H.); School of Public Health, Divisions of Epidemiology (R.L.S., W.A.H., S.S.) and Biostatistics (M.C.P.); and Department of Medicine (L.B., S.S.), Columbia-Presbyterian Medical Center, New York, NY.
Correspondence to Ralph L. Sacco, MD, MS, Neurological Institute, Room 547, Columbia-Presbyterian Medical Center, 710 W 168 St, New York, NY 10032. E-mail rls1{at}columbia.edu
Background and Purpose Risk factors for carotid atherosclerosis have been studied in white populations but infrequently in multiethnic cohorts. The aim of this study was to determine the importance of race-ethnicity and other factors associated with carotid atherosclerosis in a mixed population of Hispanics, blacks, and whites.
Methods As part of the Northern Manhattan Stroke Study, 526
stroke-free community residents (aged 
40 years; 41% men, 59% women;
46% Hispanic, 31% black, 23% white) were recruited through
random-digit dialing and had vascular risk factor evaluations. Maximum
internal carotid artery plaque thickness (MICPT) was measured with
B-mode ultrasound. The frequency distribution of MICPT was examined in
the three race-ethnic groups, and multivariate
regression was performed to identify factors that were independently
associated with MICPT.
Results Mean MICPT in the entire sample was 1.5±1.4 mm, increased directly with age, and was greater in whites and blacks than Hispanics. Other independent determinants of MICPT included smoking, glucose, LDL cholesterol, and hypertension. After we controlled for these covariates, Hispanic (versus non-Hispanic) race-ethnicity was still an independent determinant of less carotid plaque. There was a significant interaction between race-ethnicity and LDL cholesterol, with a greater effect of increasing LDL cholesterol among Hispanics.
Conclusions Atherosclerotic risk factors were predictive of MICPT in this mixed-ethnic cohort. Hispanics had significantly less carotid plaque after adjustment for other known risk factors, but they also had a greater impact of increasing LDL cholesterol.
Key Words: atherosclerosis • carotid arteries • epidemiology • racial differences • risk factors
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