Association of educational achievement with pulsatile arterial diameter change of the common carotid artery - The atherosclerosis risk in communities(ARIC) study, 1987-1992

Education is strongly inversely associated with common carotid artery intim a-media thickness in the Atherosclerosis Risk in Communities (ARIC) Study. The authors extended the ARIC study of preclinical atherosclerosis by evalu ating the cross-sectional association of education with common carotid arte ry elasticity. This study included 10,091 Black and White men and women age d 45-64 years who were free of clinical coronary heart disease and stroke/t ransient ischemic attack. Arterial elasticity was assessed by pulsatile art erial diameter change (PADC), derived from phase-locked echo-tracking. The smaller the PADC, the stiffer the artery. Education was categorized into gr ade school, high school without graduation, high school with graduation, vo cational school, some college, and graduate/professional school. PADC was d irectly associated with educational attainment. The mean PADCs, adjusted fo r age, height, diastolic diameter, systolic blood pressure, pulse pressure (linear and squared), ethnicity, gender, and smoking status, in successivel y higher education strata were 402 (standard error (SE) 5), 403 (SE 4), 407 (SE 3), 413 (SE 4), 416 (SE 2), and 417 (SE 4) mu m (p = 0.007). To the au thors' knowledge, this is the first time such an association has been repor ted. If arterial dilation impairment precedes arterial wall thickening in t he atherosclerotic process, as recent studies on endothelial dysfunction su ggest, these results indicate that low socioeconomic status may be associat ed with early arterial pathophysiologic changes-an effect that appears to b e mediated by established cardiovascular disease risk factors.