Factors of carotid arterial enlargement in a population aged 59 to 71 years - The EVA study

Background and Purpose Factors of carotid arterial enlargement are not well known in general populations. The purpose of this study was to assess the cross-sectional associations of arterial wall lesions and cardiovascular risk factors with carotid lumen diameter in elderly subjects. Methods B-mode ultrasound examinations of the carotid arteries and risk factor assessment were made in 1272 participants in the EVA (Etude sur le vieillissement arteriel) Study, a longitudinal study designed to evaluate vascular and cognitive aging in men and women aged 59 to 71 years. Ultrasound examinations included measurements of intima-media thickness (IMT) and interadventitial and lumen diameters of the common carotid arteries and quantification of atherosclerotic plaques in extracranial carotid arteries. Results Men showed greater IMT and interadventitial and lumen diameters of the common carotid arteries than did women. In both sexes, common IMT and plaque score were positively associated with common interadventitial and Lumen diameters. Stepwise multiple regression analysis showed that male sex, body height and weight, common IMT, plaque score, systolic blood pressure, and alcohol consumption were positively and independently related to lumen diameter. On the other hand, an independent negative association was observed between low-density lipoprotein cholesterol and lumen diameter. Conclusions In 59- to 71-year-old subjects, increased IMT and atherosclerotic plaques were accompanied by an increase in lumen diameter of the common carotid arteries, indicating an overcompensation. Luminal enlargement observed with several risk factors and with high blood pressure in particular might be partially counteracted by high lipid levels.