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• W1968249898 abstract "The last two decades have provided effective means of preventing cardiovascular disease and even reversing atherosclerosis. At the same time, it has become increasingly important to be able to identify subjects with preclinical atherosclerosis in order to prevent cardiovascular disease. The atherosclerotic burden can be assessed noninvasively by directly measuring the amount of plaques in the arteries with high-resolution ultrasound (Spence et al. 2002). Numerous epidemiologic studies have confirmed that plaque area, particularly in the carotid arteries, correlates well with the risk of having a cardiovascular event. Carotid arterial wall thickness, or more precisely the thickness of the intima-medial layer (IMT), is used as an alternative to the total plaque area to assess preclinical atherosclerosis. IMT is also measured by high-resolution ultrasound. It was introduced by Poli et al. in 1988 and was subsequently shown in epidemiologic studies to correlate with the risk of cardiovascular events. In the initial study, Poli found that IMT was increased in hypercholesterolemic patients compared to healthy subjects. Poli also demonstrated a correlation between IMT and age in healthy subjects, but not in the patients (Poli et al. 1988). van den Munckhof et al. are readdressing the correlation of IMT with age in this issue of Acta Physiologica (van den Munckhof, I., Scholten, R., Cable, N.T., Hopman, M.T., Green, D. & Thijssen, D. 2012. Impact of age and sex on carotid and peripheral arterial wall thickness in humans). The authors examined carotid IMT of completely healthy subjects with normal blood pressure and cholesterol levels and divided them into four groups: young and old men and women. They examined atherosclerosis prone (carotid and femoral) as well as nonatherosclerosis prone (brachial) conduit arteries. With this approach, the authors demonstrated that IMT increases with age in healthy subjects, regardless of whether the vessels are prone to atherosclerosis or not. Thus, factors unrelated to atherosclerosis may influence the age-related thickening of the arterial wall. In a recent critical review (Finn et al. 2010), it was pointed out that IMT is actually measured in an area with high shear stress (the common carotid artery), while atherosclerosis develops in areas with low shear stress (e.g. the carotid bulb). IMT will be increased in conditions with a high shear stress, such as advanced age, hypertension and diabetes. The findings of Munckhof et al. are supported by the recently published 13-year follow-up of The Tromsø study (Herder et al. 2012). The follow-up study showed that plaque area was related to traditional risk factors for atherosclerosis (blood pressure, cholesterol, smoking), while IMT was more closely related to age. Carotid IMT is well established as a cardiovascular risk factor in epidemiologic studies. It has been suggested to include carotid IMT measurements in the cardiovascular risk assessment of individual patients (Greenland et al. 2010). Considering the complex relationship between IMT and preclinical atherosclerosis, as pointed out by Munckhof et al. in this issue, and also by others (Inaba et al. 2012), this may not be advisable. None." @default.
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• W1968249898 date "2012-10-30" @default.
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• W1968249898 title "Increased arterial wall thickness - atherosclerosis or what?" @default.
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• W1968249898 doi "https://doi.org/10.1111/j.1748-1716.2012.02482.x" @default.
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