Carotid intima-media thickness, cardiovascular risk factors and albuminuria in a remote Australian Aboriginal community

Stephen McDonald, Graeme P. Maguire, Natalia Duarte, Xing Li Wang, Wendy E. Hoy

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Rates of cardiovascular disease and renal disease in Australian Aboriginal communities are high, as is the prevalence of some 'traditional' cardiovascular (CV) risk factors, such as diabetes and cigarette smoking. Recent work has highlighted the importance of markers of inflammation, such as C-reactive protein (CRP), homocysteine and albuminuria as predictors of cardiovascular risk in urban westernised settings. It is not clear how these factors relate to outcome in the setting of these remote communities, but very high CRP concentrations have been shown in this and other Aboriginal communities. In a cross-sectional survey including 237 adults in a remote Aboriginal community in the Northern Territory of Australia, we measured carotid intima-media thickness (IMT), together with blood pressure, diabetes, lipid levels, smoking and albuminuria, CRP and fibrinogen, serum homocysteine concentration, and IgG titres for Chlamydia pneumoniae, Helicobacter pylori and cytomegalovirus. Median carotid IMT was 0.63 [interquartile range 0.54-0.71] mm. As a categorical outcome, the prevalence of the highest IMT quartile ('increased IMT', ≥0.72 mm) was compared with the lower three quartiles. Increased IMT was associated in univariate analyses with greater waist circumference, systolic BP, fibrinogen and serum albumin concentrations, urine albumin/creatinine ratio and older age as continuous variables. Associations of increased IMT with some continuous variables were not linear; univariate associations were seen with the highest quartile (versus all other quartiles) of CRP and homocysteine concentration and CMV IgG titre. In a multivariate model age, smoking, waist circumference and the highest quartile of CRP concentrations (≥14 mg/l) remained significant predictors of IMT ≥0.72 mm. Measurement of carotid IMT was possible in this remote setting. Increased IMT (≥0.72 mm) was associated with increased CRP concentrations over a range that suggests infection/inflammation may be important determinants of cardiovascular risk in this setting. The associations of IMT with markers of renal disease seen in univariate analyses were explained in this analysis by confounding due to the associations of urine ACR with other risk factors.

Original languageEnglish
Pages (from-to)423-431
Number of pages9
JournalAtherosclerosis
Volume177
Issue number2
DOIs
Publication statusPublished - 1 Jan 2004
Externally publishedYes

Keywords

  • Australian Aboriginal
  • C-reactive protein
  • Carotid intima-media thickness

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this