Carotid artery intimal-medial thickness: Indicator of atherosclerotic burden and response to risk factor modification

Background A number of studies have used B-mode ultrasound to measure carotid intimal-medial thickness as an indicator of the severity of carotid atherosclerosis. Methods We reviewed the available data on carotid intimal-medial thickness in defining severity of atherosclerosis, with the use of high-quality studies that addressed clinical end points. Results Data from multiple studies demonstrate a high degree of reproducibility in measurements of intimal-medial thickness. A number of agents that include 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors, angiotensin-converting enzyme inhibitors, and insulin sensitizers reduce carotid intimal-medial thickness and cardiovascular events, such as myocardial infarction and stroke. Conclusions In this review article, various methods of measuring carotid intimal-medial thickness are examined and critiqued. In addition, the effects of various lifestyle modifications and therapeutic agents on intimal-medial thickness and cardiovascular end points are evaluated.