Context Carotid artery intima-media thickness (IMT) is associated with cardiovascular
risk factors and is recognized as an important predictive measure of clinical
coronary atherosclerosis events in middle-aged and elderly populations. However,
information on the association of carotid IMT in young adults with different
risk factors measured in childhood, adulthood, or as a cumulative burden of
each of the risk factors measured serially from childhood to adulthood is
Objective To examine the association between carotid IMT in young adults and traditional
cardiovascular risk factors measured since childhood.
Design, Setting, and Participants A cohort study of 486 adults aged 25 to 37 years from a semirural black
and white community in Bogalusa, La (71% white, 39% men), who had at least
3 measurements of traditional risk factors since childhood, conducted between
September 1973 and December 1996.
Main Outcome Measure Association of carotid IMT with risk factors, including systolic blood
pressure, lipoprotein levels, and body mass index.
Results Male vs female (0.757 mm vs 0.719 mm) and black vs white (0.760 mm vs
0.723 mm) participants had increased carotid IMT (P<.001
for both). In multivariable analyses, significant predictors for being in
top vs lower 3 quartiles of carotid IMT in young adults were childhood measures
of low-density lipoprotein cholesterol (LDL-C) level (odds ratio [OR], 1.42,
corresponding to 1-SD change specific for age, race, and sex; 95% confidence
interval [CI], 1.14-1.78) and body mass index (BMI; OR, 1.25; 95% CI, 1.01-1.54);
adulthood measures of LDL-C level (OR, 1.46; 95% CI, 1.16-1.82), high-density
lipoprotein cholesterol (HDL-C) level (OR, 0.67; 95% CI, 0.51-0.88), and systolic
blood pressure (OR, 1.36; 95% CI, 1.08-1.72); and long-term cumulative burden
of LDL-C (OR, 1.58; 95% CI, 1.24-2.01) and HDL-C (OR, 0.75; 95% CI, 0.58-0.97)
levels measured serially from childhood to adulthood. An increasing trend
in carotid IMT across quartiles of LDL-C level measured in childhood was observed,
with a mean value of 0.761 mm (95% CI, 0.743-0.780 mm) for those at the top
quartile vs 0.724 mm (95% CI, 0.715-0.734 mm) for those in the lower 3 quartiles
Conclusions Childhood measures of LDL-C level and BMI predict carotid IMT in young
adults. The prevention implications of these findings remains to be explored.