Common carotid intima-media thickness relates to cardiovascular events in adults aged <45 years

Anouk L.M. Eikendal, Karlijn A. Groenewegen, Todd J. Anderson, Annie R. Britton, Gunnar Engström, Greg W. Evans, Jacqueline De Graaf, Diederick E. Grobbee, Bo Hedblad, Suzanne Holewijn, Ai Ikeda, Kazuo Kitagawa, Akihiko Kitamura, Eva M. Lonn, Matthias W. Lorenz, Ellisiv B. Mathiesen, Giel Nijpels, Jacqueline M. Dekker, Shuhei Okazaki, Daniel H. O'LearyJoseph F. Polak, Jacqueline F. Price, Christine Robertson, Christopher M. Rembold, Maria Rosvall, Tatjana Rundek, Jukka T. Salonen, Matthias Sitzer, Coen D.A. Stehouwer, Imo E. Hoefer, Sanne A.E. Peters, Michiel L. Bots, Hester M. Den Ruijter

Research output: Contribution to journalArticlepeer-review

41 Scopus citations


Although atherosclerosis starts in early life, evidence on risk factors and atherosclerosis in individuals aged <45 years is scarce. Therefore, we studied the relationship between risk factors, common carotid intima-media thickness (CIMT), and first-time cardiovascular events in adults aged <45 years. Our study population consisted of 3067 adults aged <45 years free from symptomatic cardiovascular disease at baseline, derived from 6 cohorts that are part of the USE-IMT initiative, an individual participant data meta-analysis of general-population-based cohort studies evaluating CIMT measurements. Information on risk factors, CIMT measurements, and follow-up of the combined end point (first-time myocardial infarction or stroke) was obtained. We assessed the relationship between risk factors and CIMT and the relationship between CIMT and first-time myocardial infarction or stroke using a multivariable linear mixed-effects model and a Cox proportional-hazards model, respectively. During a follow-up of 16.3 years, 55 first-time myocardial infarctions or strokes occurred. Median CIMT was 0.63 mm. Of the risk factors under study, age, sex, diastolic blood pressure, body mass index, total cholesterol, and high-density lipoprotein cholesterol related to CIMT. Furthermore, CIMT related to first-time myocardial infarction or stroke with a hazard ratio of 1.40 per SD increase in CIMT, independent of risk factors (95% confidence interval, 1.11-1.76). CIMT may be a valuable marker for cardiovascular risk in adults aged <45 years who are not yet eligible for standard cardiovascular risk screening. This is especially relevant in those with an increased, unfavorable risk factor burden.

Original languageEnglish (US)
Pages (from-to)707-713
Number of pages7
Issue number4
StatePublished - Apr 20 2015


  • atherosclerosis
  • carotid intima-media thickness
  • risk factors
  • young adult

ASJC Scopus subject areas

  • Internal Medicine


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