Background and Purpose: Few longitudinal data about early atherosclero
tic lesions of the carotid arteries are available in general populatio
ns. The main purpose of this study was to investigate risk factors for
development and regression of intimal-medial thickening and atheromat
ous plaques. Methods: Initial and 2-year examinations of the carotid a
rteries with high-resolution B-mode ultrasonography were performed in
308 apparently healthy women aged 45 to 55 years. The development of n
ew atheromatous plaques and new intimal-medial thickening and the disa
ppearance of preexisting plaques and intimal-medial thickening defined
the four outcomes of interest. Results. The development of plaques oc
curred more frequently in women with intimal-medial thickening than in
women with normal carotid arteries at baseline (14.4% versus 7.2%, P<
.053). A regression was seen in 21.7% of the women with preexisting pl
aques. Development of intimal-medial thickening occurred in 47.5% of t
he women with normal carotid arteries whereas 20.2% of the women with
preexisting intimal-medial thickening showed a regression of their les
ions. Multiple logistic regression showed that smoking (regression coe
fficient +/-SE: 1.281+/-0.450; P<.005), baseline levels of systolic bl
ood pressure (regression coefficient +/-SE: 0.031+/-0.015; P<.04) and
apolipoprotein B (regression coefficient +/-SE: 0.016+/-0.007; P<.03)
were independently associated with the development of plaques, whereas
the presence of an intimal-medial thickening did not reach the signif
icance level (regression coefficient +/-SE: 0.639+/-0.436; P<.15). Ind
ependent predictors of the development of intimal-medial thickening we
re age (regression coefficient +/-SE: 0.124+/-0.058; P<.04) and, with
a borderline significance level, (log)triglycerides (regression coeffi
cient +/-SE: 0.854+/-0.451; P<.06). Low levels of low-density lipoprot
ein cholesterol (regression coefficient +/-SE: 0.027+/-0.009; P<.004)
were associated with its regression. Conclusions: This longitudinal st
udy emphasizes the interest of B-mode ultrasonography in the monitorin
g of early carotid lesions. It gives further support to the hypothesis
that intimal-medial thickening may be an early indicator of the ather
osclerotic process.