Predictors of Change in Carotid Artery Ultrasound in the Long Life Family StudyKline, Caitlyn (2024) Predictors of Change in Carotid Artery Ultrasound in the Long Life Family Study. Master Essay, University of Pittsburgh. This is the latest version of this item.
AbstractEarly vascular changes indicative of subclinical cardiovascular disease (CVD) can be precisely monitored using carotid ultrasound measurements such as intima-media thickness (IMT) and interadventitial diameter (IAD). This study utilized the Long Life Family Study (LLFS) dataset to explore predictors of changes in these markers over approximately 6 years (range 3.2-8.4 years) among 674 participants. Utilizing the GE LOGIQ 3 ultrasound system, we measured the absolute and annualized percent changes (APCT) in mean carotid IMT and IAD. Our analysis included age, sex, and study site as covariates in all models, and explored additional predictors such as lifestyle factors, cardiometabolic conditions, and medication use through linear regression models, adjusting for familial relatedness using Generalized Estimating Equations (GEE). The cohort had an average age of 67.5 years (range 46-90), was 43% male, with prevalence of 35% for hypertension, 6% for diabetes, and high engagement in lipid-lowering treatments (30%). Notably, 96% of the participants were non-smokers, and 80% were engaged in regular walking (>3 hours/week). Over the follow-up, we observed an annual increase of 1.08% in IMT, and 0.37% in IAD. Stratified analyses revealed that younger participants (<65 years) experienced more pronounced increases in IMT (1.37%) compared to those aged 65 and over (0.95%; P=0.004). In contrast, changes in IAD did not vary significantly by age (P=0.10) but were higher in females (0.44%) compared to males (0.29%; P=0.006). Independent predictors of vascular changes included baseline fasting glucose and smoking status, with triglycerides additionally predicting IMT changes and systolic blood pressure influencing IAD. These findings emphasize the significance of managing glucose levels and smoking cessation in mitigating age-related vascular changes, underscoring the need for ongoing research into the metabolic mechanisms influencing vascular aging. This study highlights the potential of carotid ultrasound as a tool in public health for early detection and monitoring of CVD progression, offering critical insights into the temporal dynamics of vascular health. Share
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