Association between carotid artery function and structure in the Northern Manhattan Study

David Della-Morte, Hannah Gardener, Chuanhui Dong, Matthew Markert, Digna Cabral, Mitchell S.V. Elkind, Ralph L. Sacco, Tatjana Rundek

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Background and purpose: Carotid plaque (CP), carotid intima media thickness (cIMT), and stiffness (STIFF) are pre-clinical markers of atherosclerosis and predictors of cerebrovascular disease (CVD). We sought to investigate whether STIFF is a significant determinant of cIMT and CP, which may provide an insight into the mechanism by which STIFF adds to the risk of CVD. Methods: We analyzed 876 stroke-free subjects from the Northern Manhattan Study with available ultrasound measures. To obtain the associations with STIFF, we performed multivariable-adjusted regression, negative binomial regression (for CP number), and multinomial logistic regression (for plaque area). Results: The mean age was 64 ± 9 years; 63% women and 65% Caribbean Hispanics. The mean cIMT was 0.93 ± 0.9 mm, the mean diastolic diameter 6.24 ± 0.94 mm, and STIFF 8.6 ± 6.2 ln mmHg. Prevalence of CP was 57%, and the mean total plaque area was 22.6 ± 23.0 mm2. STIFF was positively associated with cIMT but not with CP. There was an association between diastolic diameter and thick plaque. For each millimeter increase in diastolic diameter, there was about a 20% increased risk of having thick plaque (vs. no plaque). In longitudinal analyses, each millimeter increase in diastolic diameter was associated with a 37% increased risk of incident plaque. Conclusion: Increased STIFF was associated with increased cIMT and carotid artery dilatation with greater plaque burden. Increased cIMT and plaque burden represent vascular remodeling likely resulting from the two different age-related mechanisms, one that includes diffuse wall thickening (cIMT) with STIFF and another that incorporates focal atherosclerosis (plaque) with luminal dilatation.

Original languageEnglish (US)
Article number246
JournalFrontiers in Neurology
Issue numberAPR
StatePublished - Apr 16 2018


  • Arterial remodeling
  • Atherosclerosis
  • Carotid artery
  • Carotid intima media thickness
  • Carotid plaque
  • Carotid ultrasound
  • Stiffness

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology


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