Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study

Background Carotid intima‐media thickness (CIMT) and carotid distensibility are markers of arterial change; however, little is known of the association with incident heart failure (HF). We aimed to assess this. Methods This was a longitudinal analysis of data from the British Regional Heart Study, a...

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Main Authors: Atinuke Akinmolayan, A. Olia Papacosta, Lucy T. Lennon, Elizabeth A. Ellins, Julian P. J. Halcox, Peter H Whincup, S. Goya Wannamethee
Format: Article
Language:English
Published: Wiley 2025-04-01
Series:Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
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Online Access:https://www.ahajournals.org/doi/10.1161/JAHA.124.037167
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author Atinuke Akinmolayan
A. Olia Papacosta
Lucy T. Lennon
Elizabeth A. Ellins
Julian P. J. Halcox
Peter H Whincup
S. Goya Wannamethee
author_facet Atinuke Akinmolayan
A. Olia Papacosta
Lucy T. Lennon
Elizabeth A. Ellins
Julian P. J. Halcox
Peter H Whincup
S. Goya Wannamethee
author_sort Atinuke Akinmolayan
collection DOAJ
description Background Carotid intima‐media thickness (CIMT) and carotid distensibility are markers of arterial change; however, little is known of the association with incident heart failure (HF). We aimed to assess this. Methods This was a longitudinal analysis of data from the British Regional Heart Study, a prospective cohort study. A total of 1631 men aged 71 to 92 years, without a diagnosis of HF at baseline, were included. Between 2010 and 2012, participants completed a questionnaire, underwent a physical examination, and provided a fasting blood sample. CIMT and carotid artery distension were measured, and carotid distensibility was calculated. Cox proportional hazards modeling was used to assess the multivariate‐adjusted hazard ratios (HRs) of incident HF by quartiles of CIMT and distensibility, excluding men with prevalent myocardial infarction. Results The values used in the analysis were adjusted for age, social class, smoking, physical activity, alcohol status, body mass index, use of statins and antihypertensives, prevalent diabetes and stroke, pulse pressure, and presence of atrial arrhythmias. Lower carotid distensibility (bottom quartile) and higher CIMT (top quartile) were associated with increased risk of incident HF (HR, 2.55 [95% CI, 1.24–5.24]; P=0.01; and HR, 2.20 [95% CI, 1.14–4.23]; P=0.02, respectively). CIMT but not carotid distensibility was associated with incident myocardial infarction. The association between carotid distensibility and incident HF persisted after adjustment for incident myocardial infarction and CIMT (HR, 2.53 [95% CI, 1.23–5.22]; P=0.01); however, the association between CIMT and incident HF was attenuated after this adjustment (HR, 1.64 [95% CI, 0.84–3.21]; P=0.15). Conclusions Lower carotid distensibility and higher CIMT were associated with an increased risk of incident HF, despite adjustment for incident myocardial infarction.
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spelling doaj-art-c545eb81fb9b4940826370fbf3a865e52025-08-20T03:07:41ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-04-0114710.1161/JAHA.124.037167Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart StudyAtinuke Akinmolayan0A. Olia Papacosta1Lucy T. Lennon2Elizabeth A. Ellins3Julian P. J. Halcox4Peter H Whincup5S. Goya Wannamethee6Department of Primary Care and Population Health University College London London United KingdomDepartment of Primary Care and Population Health University College London London United KingdomDepartment of Primary Care and Population Health University College London London United KingdomInstitute of Life Science, Swansea University Swansea United KingdomInstitute of Life Science, Swansea University Swansea United KingdomPopulation Health Research Institute, St George’s University of London London United KingdomDepartment of Primary Care and Population Health University College London London United KingdomBackground Carotid intima‐media thickness (CIMT) and carotid distensibility are markers of arterial change; however, little is known of the association with incident heart failure (HF). We aimed to assess this. Methods This was a longitudinal analysis of data from the British Regional Heart Study, a prospective cohort study. A total of 1631 men aged 71 to 92 years, without a diagnosis of HF at baseline, were included. Between 2010 and 2012, participants completed a questionnaire, underwent a physical examination, and provided a fasting blood sample. CIMT and carotid artery distension were measured, and carotid distensibility was calculated. Cox proportional hazards modeling was used to assess the multivariate‐adjusted hazard ratios (HRs) of incident HF by quartiles of CIMT and distensibility, excluding men with prevalent myocardial infarction. Results The values used in the analysis were adjusted for age, social class, smoking, physical activity, alcohol status, body mass index, use of statins and antihypertensives, prevalent diabetes and stroke, pulse pressure, and presence of atrial arrhythmias. Lower carotid distensibility (bottom quartile) and higher CIMT (top quartile) were associated with increased risk of incident HF (HR, 2.55 [95% CI, 1.24–5.24]; P=0.01; and HR, 2.20 [95% CI, 1.14–4.23]; P=0.02, respectively). CIMT but not carotid distensibility was associated with incident myocardial infarction. The association between carotid distensibility and incident HF persisted after adjustment for incident myocardial infarction and CIMT (HR, 2.53 [95% CI, 1.23–5.22]; P=0.01); however, the association between CIMT and incident HF was attenuated after this adjustment (HR, 1.64 [95% CI, 0.84–3.21]; P=0.15). Conclusions Lower carotid distensibility and higher CIMT were associated with an increased risk of incident HF, despite adjustment for incident myocardial infarction.https://www.ahajournals.org/doi/10.1161/JAHA.124.037167cardiovascular diseasescarotid artery distensibilitycarotid intima‐media thicknessheart failure
spellingShingle Atinuke Akinmolayan
A. Olia Papacosta
Lucy T. Lennon
Elizabeth A. Ellins
Julian P. J. Halcox
Peter H Whincup
S. Goya Wannamethee
Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease
cardiovascular diseases
carotid artery distensibility
carotid intima‐media thickness
heart failure
title Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
title_full Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
title_fullStr Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
title_full_unstemmed Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
title_short Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
title_sort carotid intima media thickness carotid distensibility and incident heart failure in older men the british regional heart study
topic cardiovascular diseases
carotid artery distensibility
carotid intima‐media thickness
heart failure
url https://www.ahajournals.org/doi/10.1161/JAHA.124.037167
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