This Article  • References  • Full text PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Social Bookmarking   What's this?

The Atherosclerosis Risk in Communities Study

Donna K. Arnett, PhD; Herman A. Tyroler, MD; Gregory Burke, MD; Richard Hutchinson, MD; George Howard, PhD; Gerardo Heiss, MD, PhD

Arch Intern Med. 1996;156(17):1983-1989.

Abstract
Objective
To describe the distribution of hypertension and its association with subclinical atherosclerosis in blacks and whites.

Design
Population-based survey of 15 587 middle-aged adults from the Atherosclerosis Risk in Communities Study. Ultrasound-measured carotid artery intima media thickness (IMT) was used to estimate atherosclerosis. Hypertension was defined by the revised fifth Joint National Committee categories. Continuous systolic and diastolic blood pressure measurements also were evaluated.

Results
Among participants not reporting use of anti-hypertensive medication, 43% to 52% of black and 68% to 78% of white participants had optimal to high-normal blood pressure across the 4 study centers; 11% to 22% of black and 6% to 9% of white participants had stage I or higher hypertension. Use of antihypertensive medications was reported by 34% to 45% of blacks and 20% of whites; 11% to 17% of blacks had stage I or higher hypertension compared with 4% to 7% of whites when treated. Higher hypertension categories were associated with thicker intima medias in all ethnic and gender groups, in participants who did and did not use medications. In participants who did not use medications, multiple linear regression models adjusted for diastolic blood pressure and other risk factors found that systolic blood pressure was positively associated with IMT except in black men; diastolic blood pressure was not related to IMT in blacks and had a negative relation with IMT in white men and a J-shaped relation with IMT in white women. Results of similar direction and magnitude were found in participants who used medications.

Conclusions
Hypertension was higher in blacks than whites and was associated with subclinical atherosclerosis. The association of atherosclerosis with hypertension is accounted for predominantly by systolic blood pressure. The intriguing negative association of diastolic blood pressure and atherosclerosis implies that pulse pressure may be an important correlate of atherosclerosis.

Arch Intern Med. 1996;156:1983-1989

Author Affiliations
for the ARIC Investigators

From the Division of Epidemiology, School of Public Health, University of Minnesota, Minneapolis (Dr Arnett); the Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill (Drs Tyroler and Heiss); the Division of Public Health Sciences, Bowman Gray School of Medicine, Wake Forest University, Winston-Salem, NC (Drs Burke and Howard); and the Department of Medicine, University of Mississippi Medical Center, Jackson (Dr Hutchinson).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Racial differences in central blood pressure and vascular function in young men
Heffernan et al.
Am. J. Physiol. Heart Circ. Physiol. 2008;295:H2380-H2387.
ABSTRACT | FULL TEXT  

Arterial-ventricular coupling: mechanistic insights into cardiovascular performance at rest and during exercise
Chantler et al.
J. Appl. Physiol. 2008;105:1342-1351.
ABSTRACT | FULL TEXT  

Race-Gender Differences in the Association of Trait Anger with Subclinical Carotid Artery Atherosclerosis: The Atherosclerosis Risk in Communities Study
Williams et al.
Am J Epidemiol 2007;165:1296-1304.
ABSTRACT | FULL TEXT  

Risk Factors for Ischemic Stroke Subtypes: The Atherosclerosis Risk in Communities Study
Ohira et al.
Stroke 2006;37:2493-2498.
ABSTRACT | FULL TEXT  

Continued Decline in Blood Lead Levels Among Adults in the United States: The National Health and Nutrition Examination Surveys
Muntner et al.
Arch Intern Med 2005;165:2155-2161.
ABSTRACT | FULL TEXT  

Arterial Aging: Is It an Immutable Cardiovascular Risk Factor?
Najjar et al.
Hypertension 2005;46:454-462.
ABSTRACT | FULL TEXT  

Using MRI to Assess Aortic Wall Thickness in the Multiethnic Study of Atherosclerosis: Distribution by Race, Sex, and Age
Li et al.
Am. J. Roentgenol. 2004;182:593-597.
ABSTRACT | FULL TEXT  

Aortic Constriction Exacerbates Atherosclerosis and Induces Cardiac Dysfunction in Mice Lacking Apolipoprotein E
Wu et al.
Arterioscler. Thromb. Vasc. Bio. 2002;22:469-475.
ABSTRACT | FULL TEXT  

Differential Effects of Nifedipine and Co-Amilozide on the Progression of Early Carotid Wall Changes
Simon et al.
Circulation 2001;103:2949-2954.
ABSTRACT | FULL TEXT  

Elevated White Blood Cell Count and Carotid Plaque Thickness : The Northern Manhattan Stroke Study
Elkind et al.
Stroke 2001;32:842-849.
ABSTRACT | FULL TEXT  

Blood Pressure, LDL Cholesterol, and Intima-Media Thickness : A Test of the "Response to Injury" Hypothesis of Atherosclerosis
Sun et al.
Arterioscler. Thromb. Vasc. Bio. 2000;20:2005-2010.
ABSTRACT | FULL TEXT  

Intracranial Hemorrhage Associated With Thrombolytic Therapy for Elderly Patients With Acute Myocardial Infarction : Results From the Cooperative Cardiovascular Project
Brass et al.
Stroke 2000;31:1802-1811.
ABSTRACT | FULL TEXT  

Effects of Stress Reduction on Carotid Atherosclerosis in Hypertensive African Americans
Castillo-Richmond et al.
Stroke 2000;31:568-573.
ABSTRACT | FULL TEXT  

Increased carotid artery intimal-medial thickness: risk factor for exercise-induced myocardial ischemia in asymptomatic older individuals
Nagai et al.
Vasc Med 1999;4:181-186.
ABSTRACT  

Blood Pressure and the Progression of Carotid Atherosclerosis in Middle-Aged Men
Lakka et al.
Hypertension 1999;34:51-56.
ABSTRACT | FULL TEXT  

Increased Carotid Artery Intimal-Medial Thickness in Asymptomatic Older Subjects With Exercise-Induced Myocardial Ischemia
Nagai et al.
Circulation 1998;98:1504-1509.
ABSTRACT | FULL TEXT  

Primary Hypertension: From Pathophysiology to Prevention
Kaplan
Arch Intern Med 1996;156:1919-1920.
ABSTRACT