Sex-specific associations of cardiovascular risk factors with carotid stiffness--results from the SAPALDIA cohort study

Atherosclerosis. 2014 Aug;235(2):576-84. doi: 10.1016/j.atherosclerosis.2014.05.963. Epub 2014 Jun 11.

Abstract

Objective: Manifestation of cardiovascular disease (CVD) occurs with clear sex differences. Carotid stiffness (CS) parameters are increasingly used for CVD risk assessment but the sex-specific association with CVD risk factors as well as association patterns between CS parameters are largely unknown, which we investigated in SAPALDIA population-based cohort participants.

Methods: Risk factors of 2545 participants without clinically manifest disease were evaluated in 2001-2003 and different CS parameters were assessed in carotid ultrasound scans in 2010-2011. Stratified and non-stratified mixed linear models and multivariate regression analyses were used to examine sex-specific associations, differences and association patterns of single risk factors and CS parameters.

Results: HDL cholesterol was the only significant protective determinant of reduced CS for both sexes (ranges of CS parameters: -3.7; -0.8% of changes in geometric mean per 1SD of the risk factor on an inverted scale) and significant adverse risk factors were BMI (-0.5; 4.7%), systolic (-1.23; 4.7%) and diastolic blood pressure (1.4; 4.4%), heart rate (2.7; 7.9%), C-reactive protein (0.6; 3.3%) and smoking (-2.82; 1%), all p-values of multivariate analyses were <0.01. Sex differences with stiffer CS parameters in men were observed for increased heart rate (p = 0.001) and LDL cholesterol (p < 0.001) and in women for triglyceride (p < 0.003). Similar association patterns were found for most CS parameters.

Conclusion: Sex-specific associations of cardiovascular risk factors may reflect a sex-specific burden of atherosclerotic risk factors and similar association patterns across different CS parameters within men and women may allow the use of CS parameters in an exchangeable manner.

Keywords: Arterial stiffness; Cardiovascular risk factors; Common carotid artery; Haemodynamic properties; Ultrasound.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Blood Pressure
  • Body Mass Index
  • Cardiovascular Diseases / etiology*
  • Carotid Arteries / diagnostic imaging*
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Cohort Studies
  • Female
  • Heart Rate
  • Humans
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Risk Factors
  • Sex Characteristics*
  • Smoking / adverse effects
  • Triglycerides / blood
  • Ultrasonography
  • Vascular Stiffness*

Substances

  • Cholesterol, HDL
  • Cholesterol, LDL
  • Triglycerides