Introduction Directory UMM :Data Elmu:jurnal:A:Atherosclerosis:Vol151.Issue2.Aug2000:

Atherosclerosis 151 2000 501 – 508 Ultrasound determined carotid and femoral atherosclerosis in Lithuanian and Swedish men: the LiVicordia study M. Kristenson a, , C. Lassvik b , B. Bergdahl b , Z. Kucinskie`ne c , L. Aizienie`ne d , Ziede´n Bo b , Liselotte Scha¨fer Elinder e , A.G. Olsson b a Department of Health and En6ironment, Faculty of Health Sciences, S- 58185 Linko¨ping, Sweden b Department of Medicine and Care, Faculty of Health Sciences, S- 58185 Linko¨ping, Sweden c Department of Physiology and Biochemistry, Medical Faculty, Vilnius, Lithuania d Department of Cardiology, Medical Faculty, Vilnius, Lithuania e Department of Medicine, Karolinska Institute, Stockholm, Sweden Received 3 March 1999; received in revised form 8 September 1999; accepted 22 September 1999 Abstract Coronary heart disease mortality is four times higher in Lithuanian compared to Swedish middle-aged men. Using the same equipment Acuson XP10 with 5 MHz linear transducer and staff, we compared the amount of atherosclerosis in carotid and femoral arteries in 100 randomly sampled 50-year-old men in each of the cities Vilnius, Lithuania and Linko¨ping, Sweden. Atherosclerotic plaques were more abundant in Vilnius men compared to Linko¨ping men 53 versus 28 in the common carotid artery, 73 versus 37 in the common femoral artery, P B 0.001 for both. Plaques were thicker and more extended in arteries of Vilnius men, and an ultrasound atherosclerosis score was higher in both carotid and femoral arteries P B 0.001 for all. More Vilnius men had a maximal intima-media thickness of the common femoral artery above 1 mm P B 0.005. Stiffness in the common carotid artery was higher in Vilnius men P B 0.001. In a linear regression model of the pooled material, after adjustment for city was made, smoking, systolic blood pressure, low density lipoprotein cholesterol and b-carotene inversely significantly contributed to a high total ultrasound score r 2 = 0.32. These findings show that the higher coronary mortality noted in Lithuanian men goes together with a higher prevalence of early peripheral atherosclerosis. © 2000 Elsevier Science Ireland Ltd. All rights reserved. Keywords : Lithuania; Intima-media thickness; Plaque; Stiffness; Risk factors www.elsevier.comlocateatherosclerosis

1. Introduction

Mortality trends in coronary heart disease CHD are dramatically diverging between Eastern and Western European countries [1 – 3]. For example, the mortality in 1994 among 50 – 54-year-old men due to CHD ICD- 9 codes 410 – 414, was 436 versus 100 per 100 000 inhabitants in Lithuania and Sweden, respectively. The causes for the increasing Eastern European mortality are poorly understood [2,4]. Studies of traditional risk factors for CHD in Lithuania, i.e. serum cholesterol, blood pressure, and smoking, have shown only small differences in comparison with those in Sweden [5] and The Netherlands [6]. The present Linko¨ping – Vilnius coronary risk assessment study LiVicordia has confir- med these results [7]. New findings were that Vilnius men had lower serum concentrations of lipid-soluble antioxidant vitamins and higher susceptibility of low density lipoprotein LDL to oxidation than Linko¨ping men. Vessel wall changes in the carotid and femoral arter- ies have been found to correlate with CHD and have been suggested to serve as surrogate end points or markers for diseased coronary arteries [8 – 11]. Carotid intima-media thickness IMT has been related to risk factors for CHD [12 – 14], peripheral atherosclerosis [13,15], and degree of coronary obstruction at angiogra- phy [12]. Presence of atherosclerotic plaques had, com- Corresponding author. Tel.: + 46-13-225075; fax: + 46-13- 225095. E-mail address : margareta.kristensonlio.se M. Kristenson 0021-915000 - see front matter © 2000 Elsevier Science Ireland Ltd. All rights reserved. PII: S 0 0 2 1 - 9 1 5 0 9 9 0 0 3 9 9 - 8 pared to IMT, even stronger relations to acute myocar- dial infarction [9]. Also, an increased arterial stiffness has been suggested to be an indicator of early artery wall disease [16]. The aim of this part of the LiVicordia study was to compare the amount of atherosclerosis in the two pop- ulations by estimating IMT, number and size of atherosclerotic plaques, and wall stiffness. In addition we wanted to relate the findings to traditional and possible new risk factors for CHD.

2. Methods