Carotid Adventitial Vasa Vasorum and Intima‐Media Thickness in a Primary Prevention Population

Background Vasa vasorum ( VV ) vessels are critical in the genesis of atherosclerosis. Therefore, we assessed measures of carotid VV , intima–media thickness ( CIMT ), and patient risk factors in a primary prevention population. Methods We used multivariable linear models to evaluate the relationship between baseline covariates and a measure of carotid VV ( VV ratio) and CIMT among 324 diabetics and 141 nondiabetics. Results Median CIMT (in mm) and VV ratio among nondiabetics were 0.82 ± 0.22 and 0.80 ± 0.19, respectively, and 1.06 ± 0.19 and 1.21 ± 0.26 among diabetics (P < 0.0001). Diabetes was associated with 36% (95% CI : 24.3–48.0, P < 0.001) higher VV ratio whereas a unit change in BMI was associated with ≈1% (95% CI : 0.5–1.4, P < 0.001) change in VV ratio. A 10‐year increase in age was associated with 4% (95% CI : 1–7, P = 0.005) higher CIMT . Each 10 mmHg increase in mean systolic blood pressure was associated with 2% (95% CI : 1–4, P = 0.003) higher CIMT whereas diabetes conferred 31% (95% CI : 19.1–42.1, P < 0.001) higher CIMT . Female sex was associated with a 9% (95% CI : −12.9 to −4.1, P < 0.001) lower CIMT . Low density lipoprotein ( LDL ) cholesterol, blood pressure, and CIMT were not significantly associated with VV ratio. Conclusion In this cohort of patients with low CIMT , VV ratio, and CIMT were distinctly unrelated, but each independently associated with diabetes. VV ratio and CIMT relationships warrant further investigation in large‐scale studies and across a spectrum of atherosclerostic states.