Determinants of carotid intima-media thickness in asymptomatic elders: a population-based cross-sectional study in rural China

Objective: To examine the mean carotid intima-media thickness (CIMT) and potentially relevant determinants of increased CIMT in elders.

Method: Stroke-free and cardiovascular disease-free residents aged ≥65 years were recruited in a low-income population in China. B-mode ultrasonography was performed to measure CIMT.

Results: A total of 1039 individuals (47.9% men) were recruited. The mean CIMT value was 0.60 (SD: 0.09) mm. The mean CIMT was 24.07 (SEM: 6.52) µm greater in men than in women (P < 0.001) and 28.29 (SEM: 7.47) µm greater in patients with hypertension than in those without hypertension (P < 0.001). Moreover, the mean CIMT increased by 1.53 (SEM: 0.49) µm for each 1-year increase in age (P = 0.002). However, the mean CIMT decreased by 5.55 (SEM: 2.40) μm and 6.45 (SEM: 2.62) μm for every 1-mmol/L increase in triglyceride concentration and the high-density lipoprotein cholesterol: low-density lipoprotein cholesterol ratio, respectively (P < 0.05). However, high triglyceride level was negatively associated with mean CIMT only among individuals without metabolic syndrome (P = 0.036).

Discussion: These findings suggest that there is an urgent need to delay atherosclerosis progression and reduce the stroke burden by managing hypertension, especially for men. Moreover, to decrease the stroke burden in rural China, caution is advised regarding lipid-lowering treatment in elderly patients without metabolic syndrome.