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

Atinuke Akinmolayan Orcid Logo, A. Olia Papacosta Orcid Logo, Lucy T. Lennon Orcid Logo, Libby Ellins Orcid Logo, Julian Halcox Orcid Logo, Peter H Whincup Orcid Logo, S. Goya Wannamethee Orcid Logo

Journal of the American Heart Association, Volume: 14, Issue: 7

Swansea University Authors: Libby Ellins Orcid Logo, Julian Halcox Orcid Logo

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DOI (Published version): 10.1161/jaha.124.037167

Abstract

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,...

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Published in: Journal of the American Heart Association
ISSN: 2047-9980
Published: Wiley 2025
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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&#x2009;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&#x2010;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&#x2013;5.24]; P=0.01; and HR, 2.20 [95% CI, 1.14&#x2013;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&#x2013;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&#x2013;3.21]; P=0.15). 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RG/19/4/34452 and PG/09/024/26857). A. A. is an Academic Clinical Fellow (Award ID: ACF&#x2010;2020&#x2010;18&#x2010;012), funded by The National Institute for Health and Care Research, UK. The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health and Care Research, or the Department of Health and Social Care. 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spelling 2025-05-13T11:43:06.5859413 v2 68666 2025-01-09 Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study 553ce2abe05a6396e7dd6eadb6b90a6d 0000-0001-5164-6416 Libby Ellins Libby Ellins true false 3676f695eeda169d0f8c618adf27c04b 0000-0001-6926-2947 Julian Halcox Julian Halcox true false 2025-01-09 MEDS 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. Journal Article Journal of the American Heart Association 14 7 Wiley 2047-9980 cardiovascular diseases, carotid artery distensibility, carotid intima‐media thickness, heart failure 1 4 2025 2025-04-01 10.1161/jaha.124.037167 COLLEGE NANME Medical School COLLEGE CODE MEDS Swansea University Another institution paid the OA fee This work was supported by the British Heart Foundation (Grant Nos. RG/19/4/34452 and PG/09/024/26857). A. A. is an Academic Clinical Fellow (Award ID: ACF‐2020‐18‐012), funded by The National Institute for Health and Care Research, UK. The views expressed are those of the authors and not necessarily those of the National Health Service, the National Institute for Health and Care Research, or the Department of Health and Social Care. The funders had no role in the design and conduct of the study; collection, management, analysis, interpretation of the data; or preparation, review, approval of, or decision to publish the manuscript. RG/19/4/34452 and PG/09/024/26857, ACF-2020-18-012 2025-05-13T11:43:06.5859413 2025-01-09T11:05:24.9102981 Faculty of Medicine, Health and Life Sciences Swansea University Medical School - Health Data Science Atinuke Akinmolayan 0000-0003-1809-6576 1 A. Olia Papacosta 0000-0001-8781-6747 2 Lucy T. Lennon 0000-0002-1738-1351 3 Libby Ellins 0000-0001-5164-6416 4 Julian Halcox 0000-0001-6926-2947 5 Peter H Whincup 0000-0002-5589-4107 6 S. Goya Wannamethee 0000-0001-9484-9977 7 68666__33922__30de99a5e3ef4d4282bd6ee507c97fd6.pdf 68666.VOR.pdf 2025-04-01T15:29:24.5440951 Output 279308 application/pdf Version of Record true © 2025 The Author(s). Published on behalf of the American Heart Association, Inc., by Wiley. This is an open access article under the terms of the Creative Commons Attribution License (CC BY). true eng http://creativecommons.org/licenses/by/4.0/
title Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
spellingShingle Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
Libby Ellins
Julian Halcox
title_short 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_sort Carotid Intima‐Media Thickness, Carotid Distensibility, and Incident Heart Failure in Older Men: The British Regional Heart Study
author_id_str_mv 553ce2abe05a6396e7dd6eadb6b90a6d
3676f695eeda169d0f8c618adf27c04b
author_id_fullname_str_mv 553ce2abe05a6396e7dd6eadb6b90a6d_***_Libby Ellins
3676f695eeda169d0f8c618adf27c04b_***_Julian Halcox
author Libby Ellins
Julian Halcox
author2 Atinuke Akinmolayan
A. Olia Papacosta
Lucy T. Lennon
Libby Ellins
Julian Halcox
Peter H Whincup
S. Goya Wannamethee
format Journal article
container_title Journal of the American Heart Association
container_volume 14
container_issue 7
publishDate 2025
institution Swansea University
issn 2047-9980
doi_str_mv 10.1161/jaha.124.037167
publisher Wiley
college_str Faculty of Medicine, Health and Life Sciences
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hierarchy_top_id facultyofmedicinehealthandlifesciences
hierarchy_top_title Faculty of Medicine, Health and Life Sciences
hierarchy_parent_id facultyofmedicinehealthandlifesciences
hierarchy_parent_title Faculty of Medicine, Health and Life Sciences
department_str Swansea University Medical School - Health Data Science{{{_:::_}}}Faculty of Medicine, Health and Life Sciences{{{_:::_}}}Swansea University Medical School - Health Data Science
document_store_str 1
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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.
published_date 2025-04-01T05:26:05Z
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