Epidemiology of Carotid Artery Atherosclerosis in Youth
Condition: Atherosclerosis; Cardiovascular Diseases; Heart Diseases; Carotid Artery Diseases
MeSH terms: Carotid Artery Diseases; Cardiovascular Diseases; Heart Diseases; Atherosclerosis
Study type: Observational

Summary: 
      To examine the relationship of risk factors measured in childhood to intimal medial thickness
      (IMT) in early adulthood and to examine familial factors which may be related to increased
      IMT, a measure of atherosclerosis.
    

Detailed description: 
      BACKGROUND:

      The atherosclerotic process begins in childhood and advances through adult life when
      occlusive vascular disease results in coronary heart disease, stroke and peripheral vascular
      disease. Although risk factors have been established in adult populations, risk factors when
      measured in childhood have not been directly related to morbidity and mortality from
      occlusive atherosclerotic disease. The ultrasonographic measurement of carotid artery
      intimal-medial thickness (IMT) in adults is related not only to the risk for stroke but also
      to the severity of atherosclerotic disease in the coronary arteries. In 1970, a population of
      school age children and adolescents was first examined in Muscatine, Iowa, and since then has
      been followed to examine the predictive value of childhood risk factor levels for
      cardiovascular disease. See also Study 906 (Muscatine Heart Study).

      The study will provide a view of the significance of IMT in young adults not only in its
      relationship to risk factors in childhood and young adulthood but also to familial factors
      that may be responsible for accelerated atherosclerosis.

      DESIGN NARRATIVE:

      Beginning in 1995, the longitudinal study examined the following: 1) the relationship of body
      mass index (BMI), blood pressure, total cholesterol, and smoking behaviors measured in
      childhood to IMT measured in early adulthood; 2) the relationship of risk factors (BMI, blood
      pressure, total cholesterol, LDL-C, HDL-C, Apo A1, Apo B, Lp(a), Apo E genotypes, glucose
      insulin and smoking) to IMT in young adults; 3) the relationship of risk factor 'load' from
      childhood to adult life to IMT; 4) the relationship of IMT in young adults to familial
      mortality in first- and second-degree relatives due to vascular disease; and 5) the degree of
      familial aggregation of IMT in young adults and their parents.

      The study was renewed in FY 2000 to investigate the third generation of the Muscatine Heart
      Study cohort. The renewal determined whether the offspring of cohort members with premature
      atherosclerosis or a familial history of cardiovascular disease had increased carotid
      intimal-medial thickness (IMT) or elevated risk factors, identify risk factors for
      progression of carotid IMT, and measure putative riskfactors for increased IMT (serologic
      evidence of Chlamydia pneumoniae or cytomegalovirus infection, high sensitivity C-reactive
      protein, fibrinogen, plasminogen activator inhibitor-1 and glycosylated hemoglobin).

      The study was extended through June 2008 to measure intimal-medial thickness in a vascular
      bed affected earlier by atherosclerosis, the distal abdominal aorta, as well as in the
      carotid artery. In 662 offspring, aged 11 to 32 years, the investigators will determine if
      the aortic and carotid intimal-medial thickness are related, the relationship of
      cardiovascular risk factors to aortic intimal-medial thickness and the progression of carotid
      intimal-medial thickness, and the relationship of aortic and carotid intimal-medial thickness
      in the offspring to subclinical or clinical disease in their parents.
    

Observational model: Cohort
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        346 men and 379 women (members of original Muscatine cohort 635 members of the Muscatine
        Offspring cohort
      
Biospecimen description: 
      Blood