Sex differences in predictors of longitudinal changes in carotid artery stiffness: The multi-ethnic study of atherosclerosis

Rebecca Stern, Matthew C. Tattersall, Adam D. Gepner, Claudia E. Korcarz, Joel Kaufman, Laura A. Colangelo, Kiang Liu, James H. Stein*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

8 Scopus citations


OBJECTIVE - : To identify sex differences in predictors of longitudinal changes in carotid arterial stiffness in a multiethnic cohort. APPROACH AND RESULTS - : Carotid artery distensibility coefficient (DC) and Young's elastic modulus (YEM) were measured in 2650 Multi-Ethnic Study of Atherosclerosis participants (45-84 years old and free of cardiovascular disease) at baseline and after a mean of 9.4 years. Predictors of changes in DC and YEM for each sex were evaluated using multivariable linear regression models. The 1236 men (46.6%) were 60.0 (SD, 9.3) years: 40% were white, 22% black, 16% Chinese, and 22% Hispanic. The 1414 (53.4%) women were 59.8 (9.4) years old with a similar race distribution. Despite similar rates of change in DC and YEM, predictors of changes in distensibility markers differed by sex. In men, Chinese (P=0.002) and black (P=0.003) race/ethnicity, systolic blood pressure (P=0.012), and diabetes mellitus (P=0.05) were associated with more rapidly decreasing DC (accelerated stiffening). Starting antihypertensive medication was associated with improved DC (P=0.03); stopping antihypertensives was associated with more rapid stiffening (increased YEM, P=0.05). In women, higher education was associated with slower stiffening (DC, P=0.041; YEM, P<0.001) as was use of lipid-lowering medication (P=0.03), whereas baseline use of antihypertensive medications (YEM, P=0.01) and systolic blood pressure (DC, P=0.02; P=0.04) predicted increasing stiffening in women. CONCLUSIONS - : Longitudinal changes in carotid artery stiffness are associated with systolic blood pressure and antihypertensive therapy in both sexes; however, race/ethnicity (in men) and level of education (in women) may have different contributions between the sexes.

Original languageEnglish (US)
Pages (from-to)478-484
Number of pages7
JournalArteriosclerosis, thrombosis, and vascular biology
Issue number2
StatePublished - Feb 2 2015


  • cardiovascular diseases
  • carotid arteries
  • sex characteristics
  • vascular stiffness
  • women

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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