Top

Published in:

Open Access 01-12-2024 | Research

Common carotid artery diameter and the risk of cardiovascular disease mortality: a prospective cohort study in northeast China

Authors: Ziyi Yin, Jiajing Guo, Ru Li, Hong Zhou, Xue Zhang, Shanshan Guan, Yuanmeng Tian, Li Jing, Qun Sun, Guangxiao Li, Liying Xing, Shuang Liu

Published in: BMC Public Health | Issue 1/2024

Abstract

Background

The association between the common carotid artery (CCA) diameter and cardiovascular disease (CVD) is recognized, but the precise nature of this link remains elusive. This study aimed to investigate the potential relationship between CCA diameter and the risk of CVD mortality in a large population in northeast China.

Methods

The current study included 5668 participants (mean age 58.9 ± 10.1 years) from a population-based study conducted in rural areas of northeast China between September 2017 and May 2018. Information on death was collected from baseline until July 31, 2022. The CCA inter-adventitial diameter was measured using ultrasound. Cox proportional-hazard models were employed to explore the relationship between the common carotid artery diameter and cardiovascular mortality.

Results

At baseline, the mean CCA diameter (mm) of subjects was 7.30 ± 0.99 and increased significantly with age, ranging from 6.65 ± 0.71 among people 40–49 years to 7.99 ± 1.04 among people ≥ 80 years. CCA diameter was significantly larger in males compared to females (7.51 ± 1.03 versus vs. 7.16 ± 0.94; P < 0.001). A total of 185 participants died of CVD during a median follow-up of 4.48 years. CCA diameters were divided into quartiles, and the highest quartile of carotid diameter (≥ 8.06 mm) had a 2.29 (95% confidence interval [CI]: 1.24, 4.22) times higher risk of CVD mortality than the lowest quartile (≤ 6.65 mm) (P < 0.01) in the fully adjusted model. Each increase in the diameter of the common carotid artery (per SD) raised the risk of cardiovascular death by 36% (hazard ratio [HR]: 1.36; 95% CI: 1.18, 1.57). The subgroup analysis results demonstrated that a per SD increase was associated with a 42% increased risk of CVD mortality in participants aged ≥ 64 years in the fully adjusted model (HR: 1.42; 95%CI: 1.21, 1.66).

Conclusions

Our study indicates the possible incremental value of CCA diameter in optimizing the risk stratification of cardiovascular disease and provides essential insights into reducing the burden of cardiovascular disease.

GBD 2019 Diseases and Injuries Collaborators. Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet. 2020;396:1204–22.CrossRef

Zhao D, Liu J, Wang M, Zhang X, Zhou M. Epidemiology of cardiovascular disease in China: current features and implications. Nat Rev Cardiol. 2019;16:203–12.CrossRefPubMed

Joseph P, Leong D, McKee M, Anand SS, Schwalm J-D, Teo K, et al. Reducing the global burden of cardiovascular disease, part 1: the epidemiology and risk factors. Circ Res. 2017;121:677–94.CrossRefPubMed

Roth GA, Mensah GA, Fuster V. The global burden of cardiovascular diseases and risks. J Am Coll Cardiol. 2020;76:2980–1.CrossRefPubMed

Polak JF, Kronmal RA, Tell GS, O’Leary DH, Savage PJ, Gardin JM, et al. Compensatory increase in common carotid artery diameter: relation to blood pressure and artery intima-media thickness in older adults. Stroke. 1996;27:2012–5.CrossRefPubMed

Bots ML, Dijk JM, Oren A, Grobbee DE. Carotid intima–media thickness, arterial stiffness and risk of cardiovascular disease: current evidence. J Hypertens. 2002;20:2317–25.CrossRefPubMed

Simon A, Gariepy J, Chironi G, Megnien J-L, Levenson J. Intima–media thickness: a new tool for diagnosis and treatment of cardiovascular risk. J Hypertens. 2002;20:159–69.CrossRefPubMed

Bonithon-Kopp C, Touboul PJ, Berr C, Magne C, Ducimetière P. Factors of carotid arterial enlargement in a population aged 59 to 71 years: the EVA study. Stroke. 1996;27:654–60.CrossRefPubMed

Kawamoto R, Tomita H, Oka Y, Ohtsuka N. Association between risk factors and carotid enlargement. Intern Med. 2006;45:503–9.CrossRefPubMed

10.

Fritze F, Groß S, Ittermann T, Völzke H, Felix SB, Schminke U, et al. Carotid lumen diameter is associated with all-cause mortality in the general population. JAHA. 2020;9:e015630.CrossRefPubMedPubMedCentral

11.

Sedaghat S, van Sloten TT, Laurent S, London GM, Pannier B, Kavousi M, et al. Common carotid artery diameter and risk of cardiovascular events and mortality: pooled analyses of four cohort studies. Hypertension. 2018;72:85–92.CrossRefPubMed

12.

Anderson RN, Miniño AM, Hoyert DL, Rosenberg HM. Comparability of cause of death between ICD-9 and ICD-10: preliminary estimates. Natl Vital Stat Rep. 2001;49:1–32.PubMed

13.

Xu Y-J, Zhang M, Ji L, Elimban V, Chen L, Dhalla NS. Suppression of high lipid diet induced by atherosclerosis sarpogrelate. J Cell Mol Med. 2012;16:2394–400.CrossRefPubMedPubMedCentral

14.

Xue W, Tian Y, Jing L, Li R, Li G, Li D, et al. Sex difference in the correlation between carotid artery diameter and prevalence of stroke: Insights from a Chinese population. Int J Cardiol. 2022;353:103–8.CrossRefPubMed

15.

Xue W, Tian Y, Jing L, Li G, Yan H, Zhang B, et al. Sex-specific prediction value of common carotid artery diameter for stroke risk in a hypertensive population: a cross-sectional study. Quant Imaging Med Surg. 2022;12:1428–37.CrossRefPubMedPubMedCentral

16.

Chen P, Lin F, Huang H, Chiang H, Chang S, Chen P, et al. Diameter reduction determined through carotid ultrasound associated with cardiovascular and all-cause mortality: a single-center experience of 38 201 consecutive patients in Taiwan. JAHA. 2021;10:e023689.CrossRefPubMedPubMedCentral

17.

Montalcini T, Gorgone G, Gazzaruso C, Sesti G, Perticone F, Pujia A. Large brachial and common carotid artery diameter in postmenopausal women with carotid atherosclerosis. Atherosclerosis. 2008;196:443–8.CrossRefPubMed

18.

Steinke W, Els T, Hennerici M. Compensatory carotid artery dilatation in early atherosclerosis. Circulation. 1994;89:2578–81.CrossRefPubMed

19.

Frostegård J. Immunity, atherosclerosis and cardiovascular disease. BMC Med. 2013;11:117.CrossRefPubMedPubMedCentral

20.

Polak JF, Sacco RL, Post WS, Vaidya D, Arnan MK, O’Leary DH. Incident stroke is associated with common carotid artery diameter and not common carotid artery intima-media thickness. Stroke. 2014;45:1442–6.CrossRefPubMedPubMedCentral

21.

Meng R, Yu C, Liu N, He M, Lv J, Guo Y, et al. Association of depression with all-cause and cardiovascular disease mortality among adults in China. JAMA Netw Open. 2020;3:e1921043.CrossRefPubMedPubMedCentral

22.

Joseph P, Kutty VR, Mohan V, Kumar R, Mony P, Vijayakumar K, et al. Cardiovascular disease, mortality, and their associations with modifiable risk factors in a multi-national South Asia cohort: a PURE substudy. Eur Heart J. 2022;43:2831–40.CrossRefPubMed

Title: Common carotid artery diameter and the risk of cardiovascular disease mortality: a prospective cohort study in northeast China
Authors: Ziyi Yin
Jiajing Guo
Ru Li
Hong Zhou
Xue Zhang
Shanshan Guan
Yuanmeng Tian
Li Jing
Qun Sun
Guangxiao Li
Liying Xing
Shuang Liu
Publication date: 01-12-2024
Publisher: BioMed Central
Published in: BMC Public Health / Issue 1/2024
Electronic ISSN: 1471-2458
DOI: https://doi.org/10.1186/s12889-024-17749-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Common carotid artery diameter and the risk of cardiovascular disease mortality: a prospective cohort study in northeast China

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Please log in to get access to this content

Other articles of this Issue 1/2024

Dose-response relationship between 15 weeks of running and aerobic fitness: a retrospective analysis based on the fun running program

Linkages between the Sustainable Development Goals and health in Somalia

Association between depressive symptoms and employment type of Korean workers: the Fifth Korean Working Conditions Survey

Improving movement behavior in office workers: effects of two multi-level cluster-RCT interventions on mental health

Association of sun-seeking behaviors with indoor tanning behavior in US white females during high school/college in Nurses’ Health Study II

The impact of the COVID-19 pandemic on neurosurgery in the elderly population in Sweden