The Role of Lipid-Lowering Treatment in Carotid Intima–Media Thickness

There are a large number of studies in which carotid artery intima–media thickness (CIMT) measurements have been performed. Studies in which ultrasound measurements of CIMT were compared with histology showed that ultrasonic far wall CIMT accurately represents intima–media thickness. Despite considerable differences between ultrasound protocols the findings of reproducibility studies are reasonably similar across studies. The majority of the cross-sectional studies indicated that elevated levels of established cardiovascular risk factors, such as age, sex, total, HDL and LDL cholesterol, systolic blood pressure (BP), and body mass index (BMI) are associated with an increased CIMT.1 Subjects with certain conditions such as smoking, hypertension, diabetes mellitus, and previous coronary heart disease have increased CIMT compared to subjects without these conditions. In addition, elevated homocysteine, fibrinogen, and C-reactive protein have been associated with increased CIMT. Increased CIMT has been shown to strongly relate to atherosclerosis in the coronary arteries.2 Increased CIMT has been related to higher long-term absolute risk of stroke, coronary heart disease, and cardiovascular mortality. Several studies have examined the effect of statin therapy on the rate of progression of CIMT measured by B-mode ultrasonography. Statin therapy caused regression of CIMT compared with baseline in most of the studies.