Abstract
Background and Purpose-Subclinical atherosclerotic plaque is an important marker of increased vascular risk. Identifying factors underlying the variability in burden of atherosclerotic carotid plaque unexplained by traditional vascular risk factors may help target novel preventive strategies. Methods-As a part of the carotid substudy of the Northern Manhattan Study (NOMAS), 1790 stroke-free individuals (mean age, 69±9; 60% women; 61% Hispanic, 19% black, 18% white) were assessed for total plaque area (TPA) burden using 2-dimensional carotid ultrasound imaging. Multiple linear regression models were constructed. Model 1 used prespecified traditional risk factors: age, sex, low-density lipoprotein cholesterol, diabetes mellitus, pack-years of smoking, blood pressure, and treatment for blood pressure; and Model 2, an addition of socioeconomic and less traditional risk factors. The contributions of the components of the Framingham heart risk score and the NOMAS Global Vascular Risk Score to the TPA were explored. Results-Prevalence of carotid plaque was 58%. Mean TPA was 13±19 mm2. Model 1 explained 19.5% of the variance in TPA burden (R2=0.195). Model 2 explained 21.9% of TPA burden. Similarly, the Framingham heart risk score explained 18.8% and NOMAS global vascular risk score 21.5% of the TPA variance. Conclusions-The variation in preclinical carotid plaque burden is largely unexplained by traditional and less traditional vascular risk factors, suggesting that other unaccounted environmental and genetic factors play an important role in the determination of atherosclerotic plaque. Identification of these factors may lead to new approaches to prevent stroke and cardiovascular disease.
| Original language | English |
|---|---|
| Pages (from-to) | 1755-1760 |
| Number of pages | 6 |
| Journal | Stroke |
| Volume | 43 |
| Issue number | 7 |
| DOIs | |
| State | Published - Jul 1 2012 |
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Keywords
- carotid plaque
- carotid ultrasound
- epidemiology
- plaque area
- preclinical atherosclerosis
- risk factors
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Clinical Neurology
- Advanced and Specialized Nursing
Cite this
Traditional cardiovascular risk factors explain the minority of the variability in carotid plaque. / Kuo, Frank; Gardener, Hannah; Dong, Chuanhui; Cabral, Digna; Della Morte, David; Blanton, Susan H; Elkind, Mitchell S V; Sacco, Ralph L; Rundek, Tatjana.
In: Stroke, Vol. 43, No. 7, 01.07.2012, p. 1755-1760.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Traditional cardiovascular risk factors explain the minority of the variability in carotid plaque
AU - Kuo, Frank
AU - Gardener, Hannah
AU - Dong, Chuanhui
AU - Cabral, Digna
AU - Della Morte, David
AU - Blanton, Susan H
AU - Elkind, Mitchell S V
AU - Sacco, Ralph L
AU - Rundek, Tatjana
PY - 2012/7/1
Y1 - 2012/7/1
N2 - Background and Purpose-Subclinical atherosclerotic plaque is an important marker of increased vascular risk. Identifying factors underlying the variability in burden of atherosclerotic carotid plaque unexplained by traditional vascular risk factors may help target novel preventive strategies. Methods-As a part of the carotid substudy of the Northern Manhattan Study (NOMAS), 1790 stroke-free individuals (mean age, 69±9; 60% women; 61% Hispanic, 19% black, 18% white) were assessed for total plaque area (TPA) burden using 2-dimensional carotid ultrasound imaging. Multiple linear regression models were constructed. Model 1 used prespecified traditional risk factors: age, sex, low-density lipoprotein cholesterol, diabetes mellitus, pack-years of smoking, blood pressure, and treatment for blood pressure; and Model 2, an addition of socioeconomic and less traditional risk factors. The contributions of the components of the Framingham heart risk score and the NOMAS Global Vascular Risk Score to the TPA were explored. Results-Prevalence of carotid plaque was 58%. Mean TPA was 13±19 mm2. Model 1 explained 19.5% of the variance in TPA burden (R2=0.195). Model 2 explained 21.9% of TPA burden. Similarly, the Framingham heart risk score explained 18.8% and NOMAS global vascular risk score 21.5% of the TPA variance. Conclusions-The variation in preclinical carotid plaque burden is largely unexplained by traditional and less traditional vascular risk factors, suggesting that other unaccounted environmental and genetic factors play an important role in the determination of atherosclerotic plaque. Identification of these factors may lead to new approaches to prevent stroke and cardiovascular disease.
AB - Background and Purpose-Subclinical atherosclerotic plaque is an important marker of increased vascular risk. Identifying factors underlying the variability in burden of atherosclerotic carotid plaque unexplained by traditional vascular risk factors may help target novel preventive strategies. Methods-As a part of the carotid substudy of the Northern Manhattan Study (NOMAS), 1790 stroke-free individuals (mean age, 69±9; 60% women; 61% Hispanic, 19% black, 18% white) were assessed for total plaque area (TPA) burden using 2-dimensional carotid ultrasound imaging. Multiple linear regression models were constructed. Model 1 used prespecified traditional risk factors: age, sex, low-density lipoprotein cholesterol, diabetes mellitus, pack-years of smoking, blood pressure, and treatment for blood pressure; and Model 2, an addition of socioeconomic and less traditional risk factors. The contributions of the components of the Framingham heart risk score and the NOMAS Global Vascular Risk Score to the TPA were explored. Results-Prevalence of carotid plaque was 58%. Mean TPA was 13±19 mm2. Model 1 explained 19.5% of the variance in TPA burden (R2=0.195). Model 2 explained 21.9% of TPA burden. Similarly, the Framingham heart risk score explained 18.8% and NOMAS global vascular risk score 21.5% of the TPA variance. Conclusions-The variation in preclinical carotid plaque burden is largely unexplained by traditional and less traditional vascular risk factors, suggesting that other unaccounted environmental and genetic factors play an important role in the determination of atherosclerotic plaque. Identification of these factors may lead to new approaches to prevent stroke and cardiovascular disease.
KW - carotid plaque
KW - carotid ultrasound
KW - epidemiology
KW - plaque area
KW - preclinical atherosclerosis
KW - risk factors
UR - http://www.scopus.com/inward/record.url?scp=84863318082&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84863318082&partnerID=8YFLogxK
U2 - 10.1161/STROKEAHA.112.651059
DO - 10.1161/STROKEAHA.112.651059
M3 - Article
C2 - 22550054
AN - SCOPUS:84863318082
VL - 43
SP - 1755
EP - 1760
JO - Stroke
JF - Stroke
SN - 0039-2499
IS - 7
ER -