Ten-year time course of risk factors for increased carotid intima-media thickness: the Hoorn Study

Background Carotid artery intima-media thickness (IMT) is a measure of atherosclerosis. Levels of vascular risk factors that are associated with increased IMT change over time. This study aimed to examine the time course of vascular risk factors in older persons with 'high' versus 'low' IMT over a 10-year period. Design The Hoorn Study is a population-based cohort study on glucose metabolism and vascular disease initiated in 1989. Methods Carotid IMT was assessed in 2000-2001 (n=581) and in 2005-2007 (n=261). The time course of vascular risk factors from 1989 to 2000-2001 of the group with the highest tertile of IMT in 2000-2001 was compared with the group with the lowest tertile of IMT with linear mixed models, adjusted for age, sex, and medication use. A similar analysis was performed for change in IMT between the 2000-2001 and 2005-2007 examinations. Results Persons in the highest tertile of IMT at follow-up (2000-2001) had a higher waist circumference, BMI, systolic blood pressure, and higher total cholesterol, low-density lipoprotein cholesterol, triglycerides, fasting glucose and glycated haemoglobin levels at baseline (1989) than persons in the lowest tertile. Both groups showed a similar increase in weight, blood pressure and glucose levels over time, but persons in the highest tertile of IMT showed a greater decrease in lipid levels. None of the risk factors were associated with change in IMT over 5 years. Conclusion Persons with increased carotid IMT had an unfavourable risk factor profile throughout the preceding decade. This provides a window of opportunity for early prevention of atherosclerosis. Eur J Cardiovasc Prev Rehabil 17: 168-174