Published Online
on February 10, 2009

A more recent version of this article appeared on April 1, 2009

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Submitted on May 12, 2008
Revised on July 22, 2008
Accepted on August 20, 2008

Cardiovascular Risk Factors and Atherosclerosis in Young Women. Atherosclerosis Risk Factors in Female Youngsters (ARFY Study)

Michael Knoflach MD^*; Stefan Kiechl MD; Daniela Penz MD; Alexandra Zangerle MD; Christoph Schmidauer MD; Andrea Rossmann MD; Mahavir Shingh MD; Ralf Spallek MD; Andrea Griesmacher MD; David Bernhard PhD; Peter Robatscher MD; Waltraud Buchberger PhD; Walter Draxl MA; Johann Willeit MD; and Georg Wick MD

From the Department of Clinical Neurology (M.K., S.K., D.P., A.Z., C.S., J.W.), the Laboratory of Autoimmunity, the Division of Experimental Pathophysiology and Immunology, Biocenter (A.R., G.W.), the Central Institute for Medical and Chemical Laboratory Diagnostics (A.G.), the Department of Cardiac Surgery (D.B.), and the Clinical Department of Prosthetic Dentistry (P.R.), Innsbruck Medical University, Innsbruck, Austria; Helmholtz Centre for Infection Research (M.S.), Braunschweig, Germany; LIONEX Diagnostics & Therapeutics GmbH (R.S.), Braunschweig, Germany; and the Educational Center West for Allied Health Professions (W.B., W.D.), Tyrol State Hospital Ltd, Innsbruck, Austria.

^* To whom correspondence should be addressed. E-mail: Michael.Knoflach{at}i-med.ac.at.

Background and Purpose—Little research has been conducted into risk factors of atherosclerosis development in young women.

Methods—This cross-sectional study enrolled 205 18- to 22-year-old female students from the Educational Centre for Allied Health Professions. A broad array of risk conditions and lifestyle behaviors was carefully assessed. Intima media thickness (IMT) was used as a well-established surrogate for atherosclerosis and a predictor of vascular risk. High IMT was defined as levels exceeding the 90th percentile in the common and/or internal carotid arteries.

Results—In multivariable logistic regression analysis, systolic blood pressure, family history for hypertension, lipoprotein(a), homocysteine, T-cell immune reaction against human heat shock protein 60, and exposure to environmental tobacco smoke and exhaust gases emerged as independent predictors of high IMT. Obesity, metabolic syndrome, and classical risk factors other than high blood pressure were rare and unrelated to IMT. Findings were similar once focusing on IMT as a continuous variable.

Conclusion—In female youngsters displaying initiating stages of vascular pathology, blood pressure level and numerous nontraditional risk conditions showed a significant relation to high IMT. Our study indicates that (auto)immune processes, high lipoprotein(a), and environmental exposure to tobacco smoke and traffic exhaust may play a role in early atherogenesis.

Key words: atherosclerosis • female • human • risk factors • young adult

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