, 44:397 | Cite as

The Carotid Artery Plaque Size and Echogenicity are Related to Different Cardiovascular Risk Factors in the Elderly

The Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study
  • Jessika AnderssonEmail author
  • Johan Sundström
  • Lisa Kurland
  • Thomas Gustavsson
  • Johannes Hulthe
  • Anders Elmgren
  • Kersti Zilmer
  • Mihkel Zilmer
  • Lars Lind
Original Article


Carotid plaques can be characterised by ultrasound by size and echogenicity. Both size and echogenicity are predictors of cardiovascular events. The aim of this study was to examine whether traditional risk factors and markers of inflammation and oxidation were associated with plaque size and echogenicity. Computerised analysis of carotid plaque size and echogenicity (grey scale median, GSM) were performed by ultrasound in a population-based health survey in 1,016 subjects aged 70 years (PIVUS study). Information on cardiovascular risk factors was collected, together with markers of inflammation and oxidation. Increased Framingham risk score, systolic blood pressure, higher BMI and decreased HDL, lower glutathione levels were related to echolucent plaques. Previous or present smoking was common with significantly more pack-years related to the echorich plaques. Plaque size was associated with increased Framingham risk score, systolic blood pressure, blood glucose levels, smoking, ApoB/A1 ratio, OxLDL, TNF alpha, HOMA insulin resistance, leucocyte count, decreased BCD-LDL and low levels of l-selectin. Low HDL, increased BMI and decreased glutathione levels were associated with the echolucency of carotid plaques, implying metabolic factors to play a role for plaque composition. Markers of inflammation were related to plaque size alone, implying inflammation to be predominantly associated with the amount of atherosclerosis. These results suggest that plaque size and echogenicity are influenced by different risk factors.


Atherosclerosis Ultrasound Plaque Carotid artery Risk factor Lipids Oxidation 



The outstanding work at the endothelium laboratory performed by Nilla Fors, Jan Hall, Kerstin Marttala and Anna Stenborg in the collection and processing of the data is gratefully acknowledged. We also gratefully thank the staff at Analytical Biochemistry at AstraZeneca for performing the analyses of cytokines, chemokines, and adhesion molecules. The financial support from Uppsala University, Thureus foundation and AstraZeneca R&D is highly valued.


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Copyright information

© AOCS 2009

Authors and Affiliations

  • Jessika Andersson
    • 1
    Email author
  • Johan Sundström
    • 1
  • Lisa Kurland
    • 1
  • Thomas Gustavsson
    • 2
  • Johannes Hulthe
    • 3
    • 4
  • Anders Elmgren
    • 4
  • Kersti Zilmer
    • 5
  • Mihkel Zilmer
    • 5
  • Lars Lind
    • 1
  1. 1.Department of MedicineUppsala University HospitalUppsalaSweden
  2. 2.Department of Signals and SystemsChalmers University of TechnologyGothenburgSweden
  3. 3.Wallenberg LaboratorySahlgrenska University HospitalGothenburgSweden
  4. 4.AstraZeneca R&DMölndalSweden
  5. 5.Department of BiochemistryUniversity of TartuTartuEstonia

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