This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Stensland-Bugge, E. Articles by Njølstad, I. Search for Related Content PubMed PubMed Citation Articles by Stensland-Bugge, E. Articles by Njølstad, I. Pubmed/NCBI databases Compound via MeSH Substance via MeSH Medline Plus Health Information Carotid Artery Disease Related Collections Lipids Risk Factors Other imaging

(Stroke. 2000;31:574.)
© 2000 American Heart Association, Inc.

Original Contributions

Sex Differences in the Relationship of Risk Factors to Subclinical Carotid Atherosclerosis Measured 15 Years Later

The Tromsø Study

Eva Stensland-Bugge, MD; Kaare H. Bønaa, MD, PhD; Oddmund Joakimsen, MD Inger Njølstad, MD, PhD

From the Institute of Community Medicine, University of Tromsø (Norway).

Correspondence to Eva Stensland-Bugge, Institute of Community Medicine, University of Tromsø, N-9037 Tromsø, Norway. E-mail eva.stensland-bugge{at}ism.uit.no

Background and Purpose—Ultrasound measurement of carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Determinants of IMT in cross-sectional studies have been established, but the long-term relationship between cardiovascular risk factors and subclinical atherosclerosis has not been investigated thoroughly.

Methods—We included in the study 3128 middle-aged men and women in Tromsø, Norway, who in 1980 attended the baseline examination with measurements of cardiovascular risk factors and who underwent carotid ultrasonography after 15 years of follow-up.

Results—Age, blood pressure, total cholesterol, HDL cholesterol, and body mass index were independent long-term predictors of IMT in both men and women. Triglyceride levels were associated with an increase in IMT in women only, while physical activity and smoking were predictors of IMT in men only. However, smoking was associated with increased risk of having atherosclerotic plaque in both men and women. There were no differences in the strength of risk factor effects on IMT in the common carotid artery and the carotid bifurcation.

Conclusions—The present study indicates that established cardiovascular risk factors are independent predictors of subclinical atherosclerosis measured after 15 years of follow-up. However, there may be significant sex differences in the relationship between triglycerides, smoking, and physical activity and the risk of atherosclerosis.

Key Words: atherosclerosis • carotid arteries • follow-up studies • risk factors • ultrasonography

This article has been cited by other articles:

				A. G. Bertoni, M. C. Whitt-Glover, H. Chung, K. Y. Le, R. G. Barr, M. Mahesh, N. S. Jenny, G. L. Burke, and D. R. Jacobs The Association Between Physical Activity and Subclinical Atherosclerosis: The Multi-Ethnic Study of Atherosclerosis Am. J. Epidemiol., February 15, 2009; 169(4): 444 - 454. [Abstract] [Full Text] [PDF]

				H. M. Johnson, P. S. Douglas, S. R. Srinivasan, M. G. Bond, R. Tang, S. Li, W. Chen, G. S. Berenson, and J. H. Stein Predictors of Carotid Intima-Media Thickness Progression in Young Adults: The Bogalusa Heart Study Stroke, March 1, 2007; 38(3): 900 - 905. [Abstract] [Full Text] [PDF]

				M. Hassinen, P. Komulainen, T. A. Lakka, S. B. Vaisanen, I. Haapala, H. Gylling, M. Alen, A. Schmidt-Trucksass, A. Nissinen, and R. Rauramaa Metabolic syndrome and the progression of carotid intima-media thickness in elderly women. Arch Intern Med, February 27, 2006; 166(4): 444 - 449. [Abstract] [Full Text] [PDF]

				D. A Lawlor, S. Ebrahim, P. Whincup, J. Sterne, O. Papacosta, G. Wannamethee, S. Dhanjil, M. Griffin, A. N Nicolaides, and G. Davey Smith Sex differences in body fat distribution and carotid intima media thickness: cross sectional survey using data from the British regional heart study J Epidemiol Community Health, August 1, 2004; 58(8): 700 - 704. [Abstract] [Full Text] [PDF]

				M. L. Bots, G. W. Evans, W. A. Riley, and D. E. Grobbee Carotid Intima-Media Thickness Measurements in Intervention Studies: Design Options, Progression Rates, and Sample Size Considerations: A Point of View Stroke, December 1, 2003; 34(12): 2985 - 2994. [Abstract] [Full Text] [PDF]

				A. Oren, L. E. Vos, C. S. P. M. Uiterwaal, D. E. Grobbee, and M. L. Bots Cardiovascular Risk Factors and Increased Carotid Intima-Media Thickness in Healthy Young Adults: The Atherosclerosis Risk in Young Adults (ARYA) Study Arch Intern Med, August 11, 2003; 163(15): 1787 - 1792. [Abstract] [Full Text] [PDF]

				M. Sitzer, D. Puac, A. Buehler, D. A. Steckel, S. von Kegler, H. S. Markus, and H. Steinmetz Internal Carotid Artery Angle of Origin: A Novel Risk Factor for Early Carotid Atherosclerosis Stroke, April 1, 2003; 34(4): 950 - 955. [Abstract] [Full Text] [PDF]

				J. Luedemann, U. Schminke, K. Berger, M. Piek, S. N. Willich, A. Doring, U. John, and C. Kessler Association Between Behavior-Dependent Cardiovascular Risk Factors and Asymptomatic Carotid Atherosclerosis in a General Population Stroke, December 1, 2002; 33(12): 2929 - 2935. [Abstract] [Full Text] [PDF]

				F. Weber Risk factors for subclinical carotid atherosclerosis in healthy men Neurology, August 27, 2002; 59(4): 524 - 528. [Abstract] [Full Text] [PDF]

				J. B. Chang and T. A. Stein Ten-Year Outcome After Saphenous Vein Patch Angioplasty in Males and Females After Carotid Endarterectomy Vascular and Endovascular Surgery, January 1, 2002; 36(1): 21 - 27. [Abstract] [PDF]

				H. Tanaka, D. R. Seals, K. D. Monahan, C. M. Clevenger, C. A. DeSouza, and F. A. Dinenno Regular aerobic exercise and the age-related increase in carotid artery intima-media thickness in healthy men J Appl Physiol, April 1, 2002; 92(4): 1458 - 1464. [Abstract] [Full Text] [PDF]