Carotid Intima-media Thickness and its Association with Conventional Risk Factors in Low-income Adults: A Population-based Cross-Sectional Study in China

Abstract

Carotid intima-media thickness (CIMT) is an established predictor of cardiovascular disease and stroke. However, risk factors associated with CIMT remain unclear. Therefore, we aimed to identify factors associated with CIMT in a low-income Chinese population. Stroke-free and cardiovascular disease-free residents aged ≥45 years were recruited. B-mode ultrasonography was performed to measure CIMT. The mean age of participants (n = 3789) was 59.92 years overall, 61.13 years in men, and 59.07 years in women (P < 0.001). Male sex, older age, low education level, smoking, hypertension, and high systolic blood pressure, fasting blood glucose, and low-density lipoprotein cholesterol levels were independent determinants of mean CIMT. Mean CIMT was higher by 18.07 × 10^-3 mm in hypertensive compared to normotensive participants (P < 0.001), by 19.03 × 10^-3 mm in men compared to women (P < 0.001), and by 9.82 × 10^-3 mm in smokers compared to never smokers (P < 0.001). However, mean CIMT decreased by 1.07, 0.37, and 2.36 × 10^-3 mm per 1-unit increase in education level, diastolic blood pressure, and triglycerides, respectively. It is important to manage conventional risk factors in low-income populations to decrease stroke incidence.