COMMON CAROTID INTIMA-MEDIA THICKNESS AND LOWER-EXTREMITY ARTERIAL ATHEROSCLEROSIS - THE ROTTERDAM STUDY

High-resolution B-mode ultrasonography of the carotid arteries is used to investigate the signs of early atherosclerotic vessel wall disease . To assess whether carotid artery findings reflect atherosclerosis el sewhere, we studied the association between common carotid intima-medi a thickness and lower extremity arterial atherosclerosis among the fir st 1000 participants of the Rotterdam Study. The Rotterdam Study is a single-center population-based prospective follow-up study of 7983 sub jects, greater than or equal to 55 years old. Baseline measurements in clude ultrasound imaging of intima-media thickness of the distal commo n carotid artery and determination of the ankle-to-arm systolic blood pressure index. Lower extremity arterial disease was defined as an ank le-arm index <0.90 in at least one leg. An increase of 0.1 mm in commo n carotid artery intima-media thickness was associated with an age- an d sex-adjusted reduction of the ankle-arm index of 0.026 (95% confiden ce interval [CI]: 0.018 to 0.034). The age- and sex adjusted odds rati o of lower extremity arterial disease for subjects with an intima-medi a thickness greater than or equal to 0.89 mm (upper quintile) to that of subjects with an intima-media thickness <0.89 mm was 3.4 (95% CI: 2 .2 to 5.2). Analysis among subjects free from symptomatic cardiovascul ar disease yielded a reduction in ankle-arm index per 0.1 mm increase in intima-media thickness of 0.018 (95% CI: 0.008 to 0.028) and an odd s ratio for lower extremity arterial disease of 3.0 (95% CI: 1.7 to 5. 1). Adjustments for differences in serum lipids, hypertension, and cur rent smoking status only sightly attenuated the results. This study pr ovides evidence that increased common carotid intima-media thickness r eflects generalized atherosclerosis, as indicated by its association w ith atherosclerosis of the arteries of the lower extremities.