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Age and sex differences in the distribution and ultrasound morphology of carotid atherosclerosis: the Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature54157
Source
Arterioscler Thromb Vasc Biol. 1999 Dec;19(12):3007-13
Publication Type
Article
Date
Dec-1999
Author
O. Joakimsen
K H Bonaa
E. Stensland-Bugge
B K Jacobsen
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway. oddmund.joakimsen@ism.uit.no
Source
Arterioscler Thromb Vasc Biol. 1999 Dec;19(12):3007-13
Date
Dec-1999
Language
English
Publication Type
Article
Keywords
Adult
Age Distribution
Aged
Aged, 80 and over
Arteriosclerosis - pathology - ultrasonography
Carotid Arteries - pathology - ultrasonography
Comparative Study
Female
Humans
Male
Middle Aged
Norway - epidemiology
Prevalence
Research Support, Non-U.S. Gov't
Risk factors
Sex Distribution
Abstract
Atherosclerosis begins early in life and is the major underlying cause of cardiovascular morbidity and death. Yet, population-based information on age and sex differences in the extent and morphology of atherosclerosis throughout life is scarce. Carotid atherosclerosis can be visualized with B-mode ultrasound and is a marker of atherosclerosis elsewhere in the circulation. We assessed both the prevalence and the morphology of carotid atherosclerosis by B-mode ultrasound in 3016 men and 3404 women, 25 to 84 years old, who participated in a population health survey. The participation rate was 88%. Plaque morphology was graded according to whether a plaque was predominantly soft (echolucent) or hard (echogenic). Atherosclerotic plaques were found in 55.4% of the men and 45.8% of the women. In men, there was a linear increase with age in the prevalence of carotid atherosclerosis, whereas in women, there was a curvilinear age trend, with an inflection in the prevalence rate of women at approximately 50 years of age. The male predominance in atherosclerosis declined after the age of 50 years, the plaque prevalence being similar in elderly men and women. Men had softer plaques than women; this sex difference in plaque morphology increased significantly (P=0.005) with age. The sex difference in the prevalence of atherosclerosis and the female age trend in atherosclerosis show significant changes at the age of approximately 50 years, suggesting an adverse effect of menopause on atherosclerosis. The higher proportion of soft plaques in men compared with women increases with age and may partly account for the prevailing male excess risk of coronary heart disease in the elderly despite a similar prevalence of atherosclerosis in elderly men and women.
PubMed ID
10591682 View in PubMed
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Age and sex differences in the relationship between inherited and lifestyle risk factors and subclinical carotid atherosclerosis: the Tromsø study.

https://arctichealth.org/en/permalink/ahliterature67443
Source
Atherosclerosis. 2001 Feb 1;154(2):437-48
Publication Type
Article
Date
Feb-1-2001
Author
E. Stensland-Bugge
K H Bønaa
O. Joakimsen
Author Affiliation
Institute of Community Medicine, University of Tromso, N-9037, Tromsø, Norway. eva.stensland-bugge@ism.uit.no
Source
Atherosclerosis. 2001 Feb 1;154(2):437-48
Date
Feb-1-2001
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Aged, 80 and over
Arteriosclerosis - blood - epidemiology - etiology - ultrasonography
Carotid Arteries - ultrasonography
Carotid Artery Diseases - blood - epidemiology - etiology - ultrasonography
Comparative Study
Female
Fibrinogen - metabolism
Genetic Predisposition to Disease
Humans
Life Style
Male
Middle Aged
Norway - epidemiology
Prevalence
Questionnaires
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk factors
Sex Characteristics
Sex Factors
Triglycerides - blood
Tunica Intima - ultrasonography
Abstract
BACKGROUND: Ultrasound measurement of carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Age and sex differences in the distribution of, and risk factors for, IMT have not been investigated thoroughly. METHODS: In 1994-1995 a total of 6408 men and women aged 25-84 years living in the municipality of Tromsø, Norway, underwent ultrasound examination of carotid artery IMT and measurements of cardiovascular risk factors. RESULTS: Age, systolic blood pressure, total cholesterol, HDL cholesterol, body mass index, and smoking were independent predictors of IMT in both sexes. Fibrinogen levels and physical activity were associated with IMT in men only, whereas triglyceride levels were associated with IMT independently of HDL cholesterol in women only. A family history of cardiovascular disease (CVD) was an independent predictor of IMT in both sexes, also when controlling for traditional CVD risk factors. The magnitude of the association between most risk factors and IMT did not differ depending on age, but the effects of physical activity and triglycerides were more pronounced at higher age. CONCLUSION: These data suggest that there are significant age and sex differences in the distribution and the determinants of subclinical atherosclerosis.
PubMed ID
11166777 View in PubMed
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Low testosterone levels are associated with carotid atherosclerosis in men.

https://arctichealth.org/en/permalink/ahliterature169260
Source
J Intern Med. 2006 Jun;259(6):576-82
Publication Type
Article
Date
Jun-2006
Author
J. Svartberg
D. von Mühlen
E. Mathiesen
O. Joakimsen
K H Bønaa
E. Stensland-Bugge
Author Affiliation
Department of Medicine, University Hospital of North Norway, Tromsø, Norway. johan.svartberg@unn.no
Source
J Intern Med. 2006 Jun;259(6):576-82
Date
Jun-2006
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Anthropometry
Atherosclerosis - blood - pathology - ultrasonography
Body mass index
Carotid Stenosis - blood - pathology - ultrasonography
Cholesterol - blood
Cross-Sectional Studies
Humans
Logistic Models
Male
Middle Aged
Testosterone - blood - deficiency
Tunica Intima - pathology - ultrasonography
Tunica Media - pathology - ultrasonography
Abstract
To study the relationship between endogenous sex hormone levels and intima-media thickness (IMT) of the carotid artery measured by ultrasonography.
Population-based cross-sectional study.
Sex hormone levels measured by immunoassay, anthropometric measurements and IMT was studied in 1482 men aged 25-84 years participating in the 1994-1995 Tromsø study. The data were analysed with partial correlation, multiple linear regression and logistic regression analysis.
Linear regression models showed that total testosterone and sex hormone-binding globulin levels, but not calculated free testosterone, serum oestradiol or dehydroepiandrosterone sulphate levels were inversely associated with the age-adjusted IMT (P = 0.008 and P
PubMed ID
16704558 View in PubMed
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Population-based study of age at menopause and ultrasound assessed carotid atherosclerosis: The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature72170
Source
J Clin Epidemiol. 2000 May;53(5):525-30
Publication Type
Article
Date
May-2000
Author
O. Joakimsen
K H Bønaa
E. Stensland-Bugge
B K Jacobsen
Author Affiliation
Institute of Community Medicine, University of Tromso, N-9037, Tromso, Norway. Oddmund.Joakimsen@ism.uit.no
Source
J Clin Epidemiol. 2000 May;53(5):525-30
Date
May-2000
Language
English
Publication Type
Article
Keywords
Adult
Age Factors
Aged
Analysis of Variance
Carotid Artery Diseases - epidemiology - ultrasonography
Estrogen Replacement Therapy
Female
Humans
Menopause - physiology
Menopause, Premature
Middle Aged
Norway - epidemiology
Odds Ratio
Prevalence
Regression Analysis
Research Support, Non-U.S. Gov't
Risk factors
Abstract
Early menopause has been associated with higher prevalence and incidence of cardiovascular disease and death than late menopause, indicating that early loss of ovarian function and subsequent deficiency of estrogen may promote such diseases. No population-based studies have, however, examined the relation between age at menopause and atherosclerosis. We assessed the prevalence and the extent of carotid atherosclerosis by high-resolution B-mode ultrasound in 2588 postmenopausal women who participated in a population health survey. Information about age at menopause and menarche, parity, use of hormone replacement therapy, and prevalent diseases was collected, and cardiovascular risk factor levels were measured. Women with late menopause and women who ever had used postmenopausal estrogens had significantly less atherosclerosis than women with early menopause and those with never use of estrogen. This study provides further support for the hypothesis that estrogen protects women against cardiovascular disease.
PubMed ID
10812326 View in PubMed
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Prediction of mortality by ultrasound screening of a general population for carotid stenosis: the Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature47834
Source
Stroke. 2000 Aug;31(8):1871-6
Publication Type
Article
Date
Aug-2000
Author
O. Joakimsen
K H Bonaa
E B Mathiesen
E. Stensland-Bugge
E. Arnesen
Author Affiliation
Institutes of Community Medicine, and Clinical Medicine, University of Tromsø, Norway. Oddmund.Joakimsen@ism.uit.no
Source
Stroke. 2000 Aug;31(8):1871-6
Date
Aug-2000
Language
English
Publication Type
Article
Keywords
Aged
Blood Flow Velocity
Carotid Arteries - ultrasonography
Carotid Stenosis - mortality - physiopathology - ultrasonography
Comparative Study
Female
Humans
Male
Middle Aged
Norway - epidemiology
Predictive value of tests
Questionnaires
Research Support, Non-U.S. Gov't
Retrospective Studies
Risk factors
Survival Rate
Ultrasonography, Doppler, Color
Abstract
BACKGROUND AND PURPOSE: The extensive use of ultrasound examination of carotid arteries has revealed stenosis in many asymptomatic subjects, and clinical studies have shown that carotid stenosis is a risk factor for cardiovascular disease and death. However, information on stenosis as detected in a general population and its relation to mortality is scarce. The purpose of this population-based study was to assess whether carotid stenosis is a predictor of death. METHODS: In 1994 to 1995, 248 subjects with suspected carotid stenosis were identified among 6727 men and women 25 to 84 years of age who were examined with ultrasound. These subjects and 496 age- and sex-matched control subjects were followed up for 4.2 years, and the number and causes of deaths were registered. RESULTS: The unadjusted relative risk for death was 2.72 (95% CI, 1.57 to 4.75) for subjects with stenosis compared with control subjects. Adjusting for cardiovascular risk factors increased the relative risk to 3.47 (95% CI, 1.47 to 8.19). The adjusted relative risk in persons with stenosis and no cardiovascular disease or diabetes was 5.66 (95% CI, 1.53 to 20.90), which was higher than in subjects with stenosis and self-reported disease (1.79; 95% CI, 0.75 to 4.27). There was a dose-response relationship between degree of stenosis and risk of death (P=0.002 for linear trend). Carotid stenosis was a stronger predictor of death than self-reported cardiovascular disease or diabetes. CONCLUSIONS: Carotid stenosis is a strong and independent predictor of death.
PubMed ID
10926949 View in PubMed
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Reproducibility of ultrasonographically determined intima-media thickness is dependent on arterial wall thickness. The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature207489
Source
Stroke. 1997 Oct;28(10):1972-80
Publication Type
Article
Date
Oct-1997
Author
E. Stensland-Bugge
K H Bønaa
O. Joakimsen
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway. eva.stensland-bugge@ism.uit.no
Source
Stroke. 1997 Oct;28(10):1972-80
Date
Oct-1997
Language
English
Publication Type
Article
Keywords
Aged
Cardiovascular diseases
Carotid Artery, Common - ultrasonography
Female
Humans
Image Processing, Computer-Assisted
Male
Middle Aged
Observer Variation
Reproducibility of Results
Risk factors
Tunica Intima - ultrasonography
Tunica Media - ultrasonography
Abstract
We compared the reproducibility of B-mode ultrasonographic measurements of intima-media thickness (IMT) in various segments of the right carotid artery and examined whether measurement error was associated with IMT or cardiovascular risk factor levels.
In 1994/1995 a total of 6676 participants in the Troms? Study underwent ultrasound examination of common carotid artery IMT. Reproducibility of measurements was assessed by inviting 111 participants to a second ultrasound scan within 3 weeks of the first scan. On each occasion the subjects were examined by three sonographers.
The mean between-observer absolute differences in IMT in the far wall of the bifurcation and the near and far walls of the common carotid-artery were 0.15, 0.10, and 0.08 mm, respectively. The corresponding within-observer differences were 0.15, 0.10, and 0.06 mm, respectively. Approximately 70% to 80% of total measurement variability was due to differences among sonographers; the rest was attributable to within-reader variability. Measurement error increased significantly with increasing IMT: the increase was more than twofold over the range of measurements. Cardiovascular risk factor levels were not associated with measurement variability when we controlled for IMT.
We conclude that B-mode ultrasound provides reproducible estimates of the IMT in both the near and far walls of the carotid artery. Although measurement error is generally small, it increases proportionally with the level of IMT.
PubMed ID
9341706 View in PubMed
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Reproducibility of ultrasound assessment of carotid plaque occurrence, thickness, and morphology. The Tromsø Study.

https://arctichealth.org/en/permalink/ahliterature72670
Source
Stroke. 1997 Nov;28(11):2201-7
Publication Type
Article
Date
Nov-1997
Author
O. Joakimsen
K H Bønaa
E. Stensland-Bugge
Author Affiliation
Institute of Community Medicine, University of Tromsø, Norway. oddmund.joakimsen@ism.uit.no
Source
Stroke. 1997 Nov;28(11):2201-7
Date
Nov-1997
Language
English
Publication Type
Article
Keywords
Aged
Arteriosclerosis - ultrasonography
Cardiovascular Diseases - prevention & control
Carotid Arteries - ultrasonography
Carotid Artery Diseases - ultrasonography
Cohort Studies
Female
Follow-Up Studies
Health Surveys
Humans
Male
Mass Screening
Middle Aged
Prospective Studies
Reproducibility of Results
Research Support, Non-U.S. Gov't
Abstract
BACKGROUND AND PURPOSE: Ultrasonography is increasingly used in vascular research, but there is limited information about the reproducibility of the ultrasound method for screening purposes. In this study the reproducibility of ultrasound assessment of carotid plaque occurrence, thickness, and morphology was examined within the setting of a population health survey. METHODS: In 1994/1995, 6720 participants in the Troms? Study, Norway, underwent B-mode ultrasound scanning of the right carotid artery. The between- and within-sonographer reproducibility of ultrasound assessment of plaque occurrence and thickness was estimated by repeated scanning of a random sample of 107 participants. The between- and within-sonographer reproducibility of plaque morphology classification (echogenicity, four categories and heterogeneity, two categories) was determined by repeated reading of videotaped images of 119 randomly selected arteries with plaques. RESULTS: Between- and within-sonographer agreement on plaque occurrence was substantial with kappa values (95% CI) of 0.72 (0.60 to 0.84) and 0.76 (0.63 to 0.89), respectively. Reproducibility of plaque thickness measurements was moderate, with mean absolute differences ranging between 0.25 and 0.55 mm (coefficients of variation between 13.8% and 22.4%). Agreement on plaque morphology classification was high, with kappa values ranging between 0.54 and 0.73. CONCLUSIONS: Population screening using B-mode ultrasound provides a valuable means for the detection and morphological evaluation of carotid plaques, whereas measurements of plaque thickness are subject to considerable measurement error.
PubMed ID
9368565 View in PubMed
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Risk factors related to carotid intima-media thickness and plaque in children with familial hypercholesterolemia and control subjects.

https://arctichealth.org/en/permalink/ahliterature34707
Source
Arterioscler Thromb Vasc Biol. 1996 Aug;16(8):984-91
Publication Type
Article
Date
Aug-1996
Author
S. Tonstad
O. Joakimsen
E. Stensland-Bugge
T P Leren
L. Ose
D. Russell
K H Bønaa
Author Affiliation
Medical Department A, National Hospital, Oslo, Norway. serena.tonstad@rh.uio.no
Source
Arterioscler Thromb Vasc Biol. 1996 Aug;16(8):984-91
Date
Aug-1996
Language
English
Publication Type
Article
Keywords
Adolescent
Anthropometry
Apolipoproteins B - blood
Arteriosclerosis - etiology - pathology - ultrasonography
Carotid Arteries - pathology - ultrasonography
Carotid Stenosis - etiology - pathology - ultrasonography
Child
Female
Fibrinogen - analysis
Homocysteine - blood
Humans
Hypercholesterolemia, Familial - complications - epidemiology - pathology
Lipoprotein(a) - analysis
Male
Norway - epidemiology
Puberty
Risk factors
Sex Factors
Abstract
To assess the relationship between risk factors for cardiovascular disease and early atherosclerotic changes in the carotid artery, we measured carotid intima-media thickness by B-mode ultrasonography in 61 boys and 29 girls 10 to 19 years old with familial hypercholesterolemia (FH) and 30 control subjects matched for age and sex. All were nonsmokers, and all the FH adolescents had a known mutation in the LDL receptor gene. Mean intima-media thickness in the far wall of the carotid bulb was greater (P = .03) in the FH group than in the control subjects: 0.54 mm (95% confidence interval [CI], 0.52 to 0.56) versus 0.50 mm (95% CI, 0.47 to 0.52). In the entire group, mean and maximum intima-media thicknesses in the carotid bulb were positively associated with levels of apolipoprotein B and fibrinogen after control for pubertal stage (r = .19 to .24; P
PubMed ID
8696963 View in PubMed
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Sex differences in the relationship of risk factors to subclinical carotid atherosclerosis measured 15 years later : the Tromsø study.

https://arctichealth.org/en/permalink/ahliterature49948
Source
Stroke. 2000 Mar;31(3):574-81
Publication Type
Article
Date
Mar-2000
Author
E. Stensland-Bugge
K H Bønaa
O. Joakimsen
I. Njølstad
Author Affiliation
Institute of Community Medicine, University of Tromsø (Norway). eva.stensland-bugge@ism.uit.no
Source
Stroke. 2000 Mar;31(3):574-81
Date
Mar-2000
Language
English
Publication Type
Article
Keywords
Adult
Carotid Arteries - ultrasonography
Carotid Artery Diseases - blood - etiology - ultrasonography
Exercise - physiology
Female
Follow-Up Studies
Forecasting
Humans
Longitudinal Studies
Male
Middle Aged
Prospective Studies
Research Support, Non-U.S. Gov't
Risk factors
Sex Characteristics
Smoking - adverse effects
Triglycerides - blood
Tunica Intima - ultrasonography
Tunica Media - ultrasonography
Abstract
BACKGROUND AND PURPOSE: Ultrasound measurement of carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Determinants of IMT in cross-sectional studies have been established, but the long-term relationship between cardiovascular risk factors and subclinical atherosclerosis has not been investigated thoroughly. METHODS: We included in the study 3128 middle-aged men and women in Tromsø, Norway, who in 1980 attended the baseline examination with measurements of cardiovascular risk factors and who underwent carotid ultrasonography after 15 years of follow-up. RESULTS: Age, blood pressure, total cholesterol, HDL cholesterol, and body mass index were independent long-term predictors of IMT in both men and women. Triglyceride levels were associated with an increase in IMT in women only, while physical activity and smoking were predictors of IMT in men only. However, smoking was associated with increased risk of having atherosclerotic plaque in both men and women. There were no differences in the strength of risk factor effects on IMT in the common carotid artery and the carotid bifurcation. CONCLUSIONS: The present study indicates that established cardiovascular risk factors are independent predictors of subclinical atherosclerosis measured after 15 years of follow-up. However, there may be significant sex differences in the relationship between triglycerides, smoking, and physical activity and the risk of atherosclerosis.
PubMed ID
10700488 View in PubMed
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9 records – page 1 of 1.