Site-specific atherosclerotic plaques in the carotid arteries of middle-aged women from southern Italy - Associations with traditional risk factors and oxidation markers

Background and Pinpose-Studies on cardiovascular disease have preferentiall y involved men because of the lower frequency of the disease in preelderly women. The aim of this analysis was to examine, with the use of a standardi zed ultrasound protocol, a cohort of women to differentiate early atheroscl erotic lesions in different carotid segments in relation to traditional (li poprotein abnormalities, high blood pressure, cigarette smoking) and nontra ditional (oxidation markers) cardiovascular risk factors. Methods-More than 5000 clinically healthy, middle-aged women (n = 5062; age range, 30 to 69 years) living in the area of Naples in southern Italy part icipated in the Progetto Atena, a population-based study on the etiology of cardiovascular disease and cancer in the female population. A subsample of 310 participants underwent high-resolution B-mode ultrasound to assess int ima-media thickness of common carotid artery and carotid bifurcation. Results-Early atherosclerotic plaques (intima-media thickness >1.2 mm) were detected within the common carotid arteries in 37 women, in the carotid bi furcations in 77 women, and in both sites in 91 women. After age adjustment , common carotid plaques were found to be associated with higher systolic b lood pressure (143 versus 138 mmHg; P < 0.05) and higher body mass index (2 9 versus 27 kg/m(2); P < 0.01), while lesions at the carotid bifurcations w ere associated with higher LDL cholesterol (4.3 versus 3.8 mmol/L; P < 0.01 ) and with smoking habit. Multivariate odds ratios for the presence of comm on carotid plaques were related to antibodies against oxidized LDL (odds ra tio, 2.72; 95% CI, 1.46 to 5.07), and those for plaques at the bifurcation were related to lipid peroxides (odds ratio, 1.90; 95% CI, 1.04 to 3.47), a nd both relationships were independent of age, LDL cholesterol concentratio ns, body mass index, smoking habit, and systolic blood pressure. Conclusions-In a cohort of clinically healthy, middle-aged women, we found a site-specific association of traditional risk factors and oxidation marke rs with early atherosclerotic lesions in arterial segments differing in geo metry, shear stress, extracellular matrix composition, and cell type popula tions.