TY - JOUR
T1 - Relative importance of various risk factors for asymptomatic carotid atherosclerosis versus coronary heart disease incidence
T2 - The Atherosclerosis Risk in Communities Study
AU - Sharrett, A. Richey
AU - Sorlie, P. D.
AU - Chambless, L. E.
AU - Folsom, A. R.
AU - Hutchinson, R. G.
AU - Heiss, G.
AU - Szklo, M.
N1 - Funding Information:
This study was supported by contracts NO1-HC55015, NO1-HC55016, NO1-HC55018, NO1-HC55019, NO1-HC55020, NO1-HC55021, and NO1-HC55022 from the National Heart, Lung, and Blood Institute.
PY - 1999/5/1
Y1 - 1999/5/1
N2 - Major risk factors for coronary heart disease are also associated with early carotid artery thickening, but no studies have yet examined patterns of risk factors to see whether they differ for the two outcomes. Assuming similar pathogenesis for both coronary and carotid atherosclerosis, one could interpret risk factor pattern differences as relating to differences in staging, i.e., early atheroma versus later stenotic or occlusive atherothrombosis. This study included 12,193 Atherosclerosis Risk in Communities Study participants aged 45-64 years who were free of clinical cardiovascular disease in 1987-1989, in whom 420 myocardial infarctions or coronary heart disease deaths occurred over the next 6 years. Plasma low density lipoprotein cholesterol, systolic blood pressure, and smoking were major risk factors for both outcomes. Compared with these factors, triglycerides and high density lipoprotein (HDL) cholesterol were associated only weakly with carotid atherosclerosis but were associated strongly with coronary heart disease incidence. No other risk factors, including those associated with diabetes mellitus, hemostasis, and inflammation, differed in their relative contribution to the two outcomes. These results suggest that the high triglyceride-low HDL cholesterol pattern is involved in the transition from atheroma to atherothrombosis, and that control of this pattern may be important in persons with detectable subclinical disease.
AB - Major risk factors for coronary heart disease are also associated with early carotid artery thickening, but no studies have yet examined patterns of risk factors to see whether they differ for the two outcomes. Assuming similar pathogenesis for both coronary and carotid atherosclerosis, one could interpret risk factor pattern differences as relating to differences in staging, i.e., early atheroma versus later stenotic or occlusive atherothrombosis. This study included 12,193 Atherosclerosis Risk in Communities Study participants aged 45-64 years who were free of clinical cardiovascular disease in 1987-1989, in whom 420 myocardial infarctions or coronary heart disease deaths occurred over the next 6 years. Plasma low density lipoprotein cholesterol, systolic blood pressure, and smoking were major risk factors for both outcomes. Compared with these factors, triglycerides and high density lipoprotein (HDL) cholesterol were associated only weakly with carotid atherosclerosis but were associated strongly with coronary heart disease incidence. No other risk factors, including those associated with diabetes mellitus, hemostasis, and inflammation, differed in their relative contribution to the two outcomes. These results suggest that the high triglyceride-low HDL cholesterol pattern is involved in the transition from atheroma to atherothrombosis, and that control of this pattern may be important in persons with detectable subclinical disease.
KW - Atherosclerosis
KW - Carotid artery diseases
KW - Coronary disease
KW - Prospective studies
KW - Risk factors
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U2 - 10.1093/oxfordjournals.aje.a009900
DO - 10.1093/oxfordjournals.aje.a009900
M3 - Article
C2 - 10221321
AN - SCOPUS:0033135550
SN - 0002-9262
VL - 149
SP - 843
EP - 852
JO - American journal of epidemiology
JF - American journal of epidemiology
IS - 9
ER -