Student researcher Institut Universitaire de Cardiologie Et de Pneumologie de Québec Québec, Quebec, Canada
Background: In Canada, Indigenous peoples are at increased risk of cardiovascular (CV) disease compared to non-Indigenous populations. High-resolution magnetic resonance imaging (MRI) provides accurate measurements of carotid wall volume, an indicator of subclinical atherosclerosis, and has been used to identify individuals who are at higher risk of CV events in diverse populations. However, data on the sex-specific relationship between MRI-detected subclinical atherosclerosis and CV risk in asymptomatic Indigenous peoples remain limited. We examine the association between carotid wall volume and CV risk in First Nations men and women from the community of Wendake.
METHODS AND RESULTS: A total of 1302 asymptomatic adults (66% women) without CV disease from 8 Nations were recruited for the Canadian Alliance for Health Hearts and Minds-First Nations cohort study. CV risk was estimated using the INTERHEART risk score. Carotid wall volume was measured by MRI. The sample was divided into tertiles of atherosclerosis burden (low, moderate, high) according to sex and carotid wall volume. The INTERHEART risk score was compared between these subgroups. The present analysis focuses on a Wendat Nation population (n=188, mean age 49 ± 12 ; 37% men: 58, 63% women). Carotid wall volume was significantly associated with the INTERHEART risk score (r=0.25; p=0.002). Men had a significantly higher carotid wall volume compared to women (976.6 ± 176.3 mm³ vs. 817.7 ± 141.0 mm³; p< 0.001), despite being of comparable age. The INTERHEART risk score did not differ between men and women (14 ± 8 vs. 12 ± 6; p=0.13). Among women, no significant differences in age or INTERHEART risk score were observed between carotid wall volume tertiles. Among men, age (40 ± 10 vs. 52 ± 10 years; p=0.01) and INTERHEART risk score (8 ± 6 vs. 15 ± 8; p=0.03) were significantly increased between subgroups with low vs. high carotid wall volume; however, these differences were no longer significant after adjusting for age (p=0.55).
Conclusion: In the community of Wendake, men exhibited a greater burden of carotid subclinical atherosclerosis than women. Among men, higher carotid wall volume was associated with increase CV risk, largely driven by age. Further work with the community of Wendake may enable more tailored CV risk prediction in the future.
