Introduction:
Cardiovascular disease (CVD) remains the number one cause of mortality in the western world. Carotid intimal media thickness (carotid IMT) is a safe and reliable predictor of future CVD risk.
Hypothesis:
The study aims to assess the hypothesis that lifestyle factors impact carotid IMT, and determine which nutrition and fitness risk factors best predict mean carotid IMT scores.
Methods:
A prospective cross-sectional analysis of 592 men and women undergoing health and cardiovascular risk screening. This study reflects the first visit of these subjects, age 23 to 65 (mean = 48.2), who are followed longitudinally and who were participants at a “wellness” oriented program for patients who are generally well-educated and mostly in good health. Measurements were made of fitness using VO2max stress testing and push-up and sit-up scores following the American College of Sports Medicine testing protocols, diet intake using a 3-day dietary intake survey and computerized analyses. Mean carotid IMT scores were obtained using high resolution B-mode ultrasonography of the common carotid arteries. Each subject had ≥10 images collected from the far wall of the right and left distal 1 cm of the common carotid arteries at end diastole. The carotid intimal thickness was measured as a continuous variable, using both multivariate linear and bivariate linear regression. Multivariate analyses adjusted for potential confounders using multiple linear regression and included measures of body composition, blood pressure, fasting lipid and glucose levels, and statin use.
Results:
Multivariate analyses show that higher mean carotid IMT values are associated with increasing age (p<0.0001), male gender (p<.0.0001), lower aerobic capacity (p=0.0045), lower intake of fish (p=0.05), and lower intake of zinc (p=0.0002). Bivariate analyses controlling for age and gender, with and without statin use, showed higher mean carotid IMT scores were statistically associated with lower levels of aerobic fitness, (p = 0.0007), lower intake of fiber (p=0.02) and lower intake of magnesium (p=0.019). Intake of protein, carbohydrate, and fat as percent of calories; as well as intake of saturated fat, sodium, calcium, potassium, and vitamin K; measures of strength (assessed with push-up and sit-up testing); and self-reported exercise minutes per week were not associated with mean carotid IMT scores.
Conclusions:
In this database, aerobic fitness and dietary intake of fiber, fish, magnesium, and zinc are associated with lower carotid IMT scores. Further studies are warranted to explore the impact of emerging lifestyle factors on cardiovascular risk and clinical outcomes.
Bilateral Displacement of the Common Carotid Arteries by a Large Goiter
