02927nas a2200349 4500008004100000022001400041245013000055210006900185260001300254300001100267490000700278520189700285653003502182653002402217653001902241653002402260653001102284653002202295653001102317653003402328653001402362653000902376653001602385653002402401653001702425100002102442700002102463700002002484700001702504700002002521856003602541 2011 eng d a1524-462800aCarotid intima-media thickness, electrocardiographic left ventricular hypertrophy, and incidence of intracerebral hemorrhage.0 aCarotid intimamedia thickness electrocardiographic left ventricu c2011 Nov a3075-90 v423 a

BACKGROUND AND PURPOSE: Carotid intima-media thickness and electrocardiographic left ventricular hypertrophy are 2 subclinical cardiovascular disease measures associated with increased risk of total and ischemic strokes. Increased intima-media thickness and electrocardiographic left ventricular hypertrophy also may reflect end-organ hypertensive effects. Information is scant on the associations of these subclinical measures with intracerebral hemorrhage (ICH). We hypothesized that greater carotid intima-media thickness and the presence of electrocardiographic left ventricular hypertrophy would be independently associated with increased ICH incidence.

METHODS: Among 18,155 participants initially free of stroke in the Atherosclerosis Risk in Communities Study (ARIC) and the Cardiovascular Health Study (CHS), we assessed carotid intima-media thickness, carotid plaque, and electrocardiographic left ventricular hypertrophy. Over a median of 18 years of follow-up, 162 incident ICH events occurred.

RESULTS: After adjustment for other ICH risk factors, carotid intima-media thickness was associated positively with incidence of ICH in both ARIC and CHS. The risk was lowest in study-specific Quartile 1, elevated 1.6- to 2.6-fold in Quartiles 2 to 3, and elevated 2.5 to 3.7-fold in Quartile 4 (P<0.05 for both studies). In CHS, having a carotid plaque was associated with a 2-fold (95% CI, 1.1-3.4) greater ICH risk than having no plaque, but only 1.2-fold (95% CI, 0.76-2.0) greater ICH risk in ARIC. Electrocardiographic left ventricular hypertrophy carried a hazard ratio of ICH of 1.7 (95% CI, 0.77-3.7) in CHS and 2.8 (95% CI, 1.2-6.4) in ARIC.

CONCLUSIONS: Our data suggest that people with carotid atherosclerosis and possibly left ventricular hypertrophy are at increased risk not only of ischemic stroke, but also of ICH.

10aCarotid Intima-Media Thickness10aCerebral Hemorrhage10aCohort Studies10aElectrocardiography10aFemale10aFollow-Up Studies10aHumans10aHypertrophy, Left Ventricular10aIncidence10aMale10aMiddle Aged10aProspective Studies10aRisk Factors1 aFolsom, Aaron, R1 aYatsuya, Hiroshi1 aPsaty, Bruce, M1 aShahar, Eyal1 aLongstreth, W T uhttps://chs-nhlbi.org/node/1331