Cardiovascular Journal of Africa: Vol 29 No 3 (May/Junel 2018)

58 / 76

CARDIOVASCULAR JOURNAL OF AFRICA • Volume 29, No 3, May/June 2018 188 AFRICA
of the carotid artery. However, while prospective studies, which
will generate IMT data in the carotid bulb and ICA are pending,
our findings provide important insights into the determinants
of subclinical CA in this population. Most of the subjects in
the present study presented with more than one risk factor and
received more than one medical therapy. However, assessment of
the effects of each medication on each risk factor, as well as the
effects of the prescribed medication on CIMT was not performed.
Conclusion
This study provides evidence that a linear, graded and independent
association exists between CVRFs and CIMT and that the risk
of CP increases with increasing number of CVRFs. Age ≥ 50
years, hypertension, obesity and alcohol intake > 20 g/day were
independent contributors to CIMT variance, while age ≥ 50
years and hypertension were the contributors to CP variance.
About 21.3% of CCA IMT and 62.0% of CP could not be
explained by traditional CVRFs in this study. This observation
represents strong evidence to encourage future studies focusing
on the influence of novel CVRFs on CIMT and CP.
References
1. Yang C, Sun Z, Li Y, Ai J, Sun O, Tian Y. The correlation between serum
lipid profile with carotid intima media thickness and plaque. BMC
Cardiovasc Disord 2014; 14: 181–189.
2. Tattersall MC, Gassett A, Korcarz CE, Gepner AD, Kaufman JD, Liu
KJ, et al . Predictors of carotid thickness and plaque progression during
a decade: the multi-ethnic study of atherosclerosis. Stroke 2014; 45:
3257–3262.
3. McGill HC Jr, McMahan CA, Gidding SS. Preventing heart disease
in the 21st century: implications of the Pathobiological Determinants
of Atherosclerosis in Youth (PDAY) Study. Circulation 2008; 117:
1216–1227.
4. Yusuf S, Hawken S, Ôunpuu S, Dans T, Avezum A, Lanas F, et al. Effect
of potentially modifiable risk factors associated with myocardial infarc-
tion in 52 countries (the interheart study): Case-control study. Lancet
2004; 364: 937–952.
5. O’Donnell MJ, Xavier D, Liu L, Zhang H, Chin SL, Rao-Melacini P, et
al. Risk factors for ischemic and intracerebral haemorrhagic stroke in
22 countries (the interstroke study): A case- control study. Lancet 2010;
376: 112–123.
6. Ren L, Cai J, Liang J, Li W, Sun Z. Impact of cardiovascular risk
factors on carotid intima–media thickness and degree of severity: a
cross-sectional study. PLoS One 2015; 10(12): e0144182. doi: 10.1371/
journal.pone.0144182.
7. Zhang F, Feng L, Chen Y, Geng Z, Xu X. Relationship between
carotid artery intima–media thickness and cardiovascular risk factors
in Chinese Uygur population. Int J Clin Exp Med2014; 7: 5412–5420.
8. Kuo F, Gardener H, Dong C, Cabral D, Della-Morte D, Blanton SH,
et al. Traditional cardiovascular risk factors explain the minority of the
variability in carotid plaque. Stroke 2012; 43: 1755–1760.
9. Naqvi TZ, Lee MS. Carotid intima–media thickness and plaque in
cardiovascular risk assessment. J Am Coll Cardiol Cardiovasc Imaging
2014; 7: 1025–1038.
10. Expert Panel on Detection and Treatment of High Blood Cholesterol
in Adults. Executive Summary of the Third Report of the National
Cholesterol Education Program (NCEP) Expert Panel on Detection,
Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult
Treatment Panel III). J Am Med Assoc 2001; 285: 2486–2497.
11. Bonita R, Courten M, Dwyer T, Jamrozik K, Winkelmann R.
Surveillance of risk factors for noncommunicable disease: The WHO
STEP wise approach. Summary. Geneva: WHO; 2001.
12. Touboul PJ, Hennerici MG, Meairs S, Adams H, Amarenco P, Bornstein
N, et al. Mannheim carotid intima–media thickness and plaque consen-
sus (2004–2006–2011). An update on behalf of the advisory board
of the 3rd, 4th and 5th watching the risk symposia, at the 13th, 15th
and 20th European Stroke Conferences, Mannheim, Germany, 2004,
Brussels, Belgium, 2006, and Hamburg, Germany, 2011. Cerebrovasc
Dis 2012; 34: 290–296.
13. Umeh EO, Agunloye AM, Adekanmi AJ, Adeyinka AO. Ultrasound
evaluation of intima–media thickness of carotid arteries in adults with
primary hypertension at Ibadan, Nigeria. West Afr J Med 2013; 32(1):
62–67.
14. Akintunde AA, Salawu AA, Opadijo OG. Prevalence of traditional
cardiovascular risk factors among staff of Ladoke Akintola University
of technology, Ogbomoso, Nigeria. Niger J Clin Pract 2014; 14:
750–755.
15. Sani MU, Wahab KW, Yusuf BO, Gbadamosi M, Johnson OV,
Gbadamosi A. Modifiable cardiovascular risk factors among apparently
healthy adult Nigerian population – A cross sectional study. BMC Res
Notes 2010; 3:11. Doi: 10.1186/1756-0500-3-11.
16. Pozza RD, Beyerlein A, Thilmany C, Weissenbacher C, Netz H, Schmidt
H, Bechtold S. The effect of cardiovascular risk factors on the longi-
tudinal evolution of the carotid intima medial thickness in children
with type 1 diabetes mellitus. Cardiovasc Diabetol 2011; 10: 53. Doi:
10.1186/1475-2840-10-53.
17. Okeahialam BN, Alonge BA, Pam SD, Puepet FH. Carotid intima
media thickness as a measure of cardiovascular disease burden in
Nigerian Africans with hypertension and diabetes mellitus. Int J Vasc
Med 2011; 2011: 327171. doi: 10.1155/2011/327171. Epub 2011 May 23.
18. Ayoola OO, Onuwaje AM, Akintomide AO. Sonographic assessment
of the carotid intima-media thickness on B-mode ultrasonography in a
Nigerian population. Niger Med J 2015; 56(5): 357–361.
19. Ibinaiye PO, Kolade-Yinusa HO, Abdukadir A, Yinusa T. Relationship
of carotid artery intima media thickness to blood pressure, age and body
mass index of hypertensive adult patients. Arch Int Surg 2015; 5: 63–68.
20. Baroncici LAV, Sylvestre LC, Filho RP. Carotid intima–media thickness
and carotid plaque represent different adaptive responses to traditional
cardiovascular risk factors. Int J Cardiol Heart Vasc 2015; 9: 48–51.
21. Urbina EM, Kimball TR, McCoy CE, Khoury PR, Daniels SR, Dolan
LM. Youth with obesity and obesity-related type 2 diabetes mellitus
demonstrate abnormalities in carotid structure and function. Circulation
2009; 119: 2913–2919.
22. Niu L, Zhang Y, Qian M, Meng L, Xiao Y, Wang Y, et al. Impact of
multiple cardiovascular risk factors on carotid intima–media thick-
ness and elasticity. PLoS One 2013; 8: e67809. doi: 10.1371/journal.
pone.0067809.
23. Wang W, Wu YF, Zhao D, Yang Y, Lang LR, Wang M, et al.
Distribution characteristics and risk factors of carotid atherosclerosis
in middle-aged and elderly Chinese. Chin J Cardiol 2010; 38: 553–557.
24. Santos IS, Alencar AP, Rundek T, Goulart AC, Barreto SM, Pereira AC,
et al. Low impact of traditional risk factors on carotid intima-media
thickness: the ELSA–Brasil cohort. Arterioscler Thromb Vasc Biol 2015;
35: 2054–2059.
25. Lanktree MB, Hegele RA, Schork, Spence JD. Extremes of unexplained
variation as a phenotype: an efficient approach for genome-wide asso-
ciation studies of cardiovascular disease. Circ Cardiovasc Genet 2010;
3(2): 215–221.