RELATIONSHIP BETWEEN CAROTID INTIMA-MEDIA THICKNESS AND SYMPTOMATIC AND ASYMPTOMATIC PERIPHERAL ARTERIAL-DISEASE - THE EDINBURGH ARTERY STUDY

Background and Purpose Ultrasonic evaluation of intima-media thickness (IMT) is one method of assessing the development of early atheroscler osis. This report describes the distribution of IMT within the general population and is one of the first to investigate its association wit h noninvasively assessed symptomatic and asymptomatic peripheral arter ial disease. Methods Ultrasonic evaluation of IMT was included in the 5-year follow-up examination of participants of the Edinburgh Artery S tudy. Valid readings of IMT were recorded in 1106 subjects aged 60 to 80 years, and the maximum from the right and left sides of the neck wa s used in tile analysis. Existing symptomatic and asymptomatic periphe ral arterial disease and coronary heart disease were also assessed at follow-up using previously validated noninvasive techniques. Results I MT increased continuously with age (P less than or equal to.01), and i ts distribution was positively skewed in both sexes. The results sugge st that levels of atherosclerotic development in the common carotid ar tery are 5 to 10 years more advanced in men than in women. In this pop ulation, the overall prevalence of moderate to severe disease was very low (only 1.2% of study participants had IMT values >2 mm). The prese nce of symptomatic (intermittent claudication) or asymptomatic (ankle brachial pressure index less than or equal to 0.9) peripheral arterial disease was significantly associated with increased IMT (P less than or equal to.05). Conclusions Although tile prevalence of advanced athe rosclerosis was very low. small changes in IMT were associated with cl inically significant development of atherosclerosis in the peripheral arteries. However, further longitudinal studies are needed that standa rdize measurement techniques and would allow accurate comparisons acro ss studies.