{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T11:53:43Z","timestamp":1770724423824,"version":"3.49.0"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2018,2,7]],"date-time":"2018-02-07T00:00:00Z","timestamp":1517961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100005C"],"award-info":[{"award-number":["HHSN268201100005C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100006C"],"award-info":[{"award-number":["HHSN268201100006C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100007C"],"award-info":[{"award-number":["HHSN268201100007C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN26820 1100008C"],"award-info":[{"award-number":["HHSN26820 1100008C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100009C"],"award-info":[{"award-number":["HHSN268201100009C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100010C"],"award-info":[{"award-number":["HHSN268201100010C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100011C"],"award-info":[{"award-number":["HHSN268201100011C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["HHSN268201100012C"],"award-info":[{"award-number":["HHSN268201100012C"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,7,16]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>BACKGROUND<\/jats:title>\n                  <jats:p>Both hypertensive and atherosclerotic processes contribute to common carotid artery intima-media thickness (CCA-IMT). Elevated CCA-IMT may be indicative of subclinical cerebrovascular disease; however, its role in the absence of concomitant carotid artery plaque is uncertain, and few studies have examined associations in Black populations.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>MATERIALS AND METHODS<\/jats:title>\n                  <jats:p>At cohort visit 3 (1993\u20131995) a subset of stroke-free participants (641 Blacks and 702 Whites, mean age 63) from the Atherosclerosis Risk in Communities (ARIC) study was imaged by brain MRI and carotid ultrasound. A CCA-IMT &amp;gt;0.9 mm was considered elevated. Asymptomatic brain lesions \u22653 mm were considered silent brain infarctions (SBI). Subcortical SBI measuring 3 to &amp;lt;20 mm were considered lacunes. Associations between elevated CCA-IMT and SBI were analyzed with Poisson regression.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>RESULTS<\/jats:title>\n                  <jats:p>Elevated CCA-IMT was identified in 168 participants (16% of Blacks, 10% of Whites), and SBI were observed in 156 (15% of Blacks, 8% of Whites). Elevated CCA-IMT was strongly related to anterior circulation SBI, posterior circulation SBI, and lacunes. After adjustments, elevated CCA-IMT remained associated with greater number of lacunes in Blacks ([prevalence ratio, PR] = 1.60; 95% confidence interval [CI]: 1.02\u20132.51), but not Whites (PR = 0.85; 95% CI: 0.35\u20132.04); P value for interaction = 0.12. Among Black participants without concomitant carotid plaque, elevated CCA-IMT was associated with twice the number of lacunes (PR = 2.00; 95% CI: 1.05\u20133.82).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>CONCLUSIONS<\/jats:title>\n                  <jats:p>In older Black adults, elevated CCA-IMT is independently associated with lipohyalinosis of the cerebral small vessels, irrespective of concomitant carotid plaque and vascular risk factors.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ajh\/hpy022","type":"journal-article","created":{"date-parts":[[2018,2,6]],"date-time":"2018-02-06T12:08:08Z","timestamp":1517918888000},"page":"869-875","source":"Crossref","is-referenced-by-count":21,"title":["Carotid Intima-Media Thickness and Silent Brain Infarctions in a Biracial Cohort: The Atherosclerosis Risk in Communities (ARIC) Study"],"prefix":"10.1093","volume":"31","author":[{"given":"Melissa C","family":"Caughey","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Cardiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ye","family":"Qiao","sequence":"additional","affiliation":[{"name":"Department of Radiology, Johns Hopkins Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Beverly Gwen","family":"Windham","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca F","family":"Gottesman","sequence":"additional","affiliation":[{"name":"Department of Neurology, Johns Hopkins Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H","family":"Mosley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Geriatrics, University of Mississippi Medical Center, Jackson, Mississippi, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bruce A","family":"Wasserman","sequence":"additional","affiliation":[{"name":"Department of Radiology, Johns Hopkins Medicine, Baltimore, Maryland, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2018,2,7]]},"reference":[{"key":"2022101717470582900_CIT0001","doi-asserted-by":"crossref","first-page":"1025","DOI":"10.1016\/j.jcmg.2013.11.014","article-title":"Carotid intima-media thickness and plaque in cardiovascular risk assessment","volume":"7","author":"Naqvi","year":"2014","journal-title":"JACC Cardiovasc Imaging"},{"key":"2022101717470582900_CIT0002","doi-asserted-by":"crossref","first-page":"1399","DOI":"10.1161\/01.CIR.74.6.1399","article-title":"Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging","volume":"74","author":"Pignoli","year":"1986","journal-title":"Circulation"},{"key":"2022101717470582900_CIT0003","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/S0140-6736(07)61088-5","article-title":"Torcetrapib and carotid intima-media thickness in mixed dyslipidaemia (RADIANCE 2 study): a randomised, double-blind trial","volume":"370","author":"Bots","year":"2007","journal-title":"Lancet"},{"key":"2022101717470582900_CIT0004","doi-asserted-by":"crossref","first-page":"1951","DOI":"10.3174\/ajnr.A2214","article-title":"Carotid intima-media thickness is greater but carotid plaque prevalence is lower in Black compared with White subjects","volume":"31","author":"Mackinnon","year":"2010","journal-title":"AJNR Am J Neuroradiol"},{"key":"2022101717470582900_CIT0005","doi-asserted-by":"crossref","first-page":"1432","DOI":"10.1161\/01.CIR.96.5.1432","article-title":"Common carotid intima-media thickness and risk of stroke and myocardial infarction: the Rotterdam Study","volume":"96","author":"Bots","year":"1997","journal-title":"Circulation"},{"key":"2022101717470582900_CIT0006","doi-asserted-by":"crossref","first-page":"1217","DOI":"10.1001\/archneur.55.9.1217","article-title":"Lacunar infarcts defined by magnetic resonance imaging of 3660 elderly people: the Cardiovascular Health Study","volume":"55","author":"Longstreth","year":"1998","journal-title":"Arch Neurol"},{"key":"2022101717470582900_CIT0007","doi-asserted-by":"crossref","first-page":"1126","DOI":"10.1161\/01.STR.0000068408.82115.D2","article-title":"Silent brain infarcts and white matter lesions increase stroke risk in the general population: the Rotterdam Scan Study","volume":"34","author":"Vermeer","year":"2003","journal-title":"Stroke"},{"key":"2022101717470582900_CIT0008","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1161\/01.ATV.19.2.356","article-title":"Relationships of cerebral MRI findings to ultrasonographic carotid atherosclerosis in older adults: the Cardiovascular Health Study. CHS Collaborative Research Group","volume":"19","author":"Manolio","year":"1999","journal-title":"Arterioscler Thromb Vasc Biol"},{"key":"2022101717470582900_CIT0009","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1161\/01.STR.0000052631.98405.15","article-title":"Incidence and risk factors of silent brain infarcts in the population-based Rotterdam Scan Study","volume":"34","author":"Vermeer","year":"2003","journal-title":"Stroke"},{"key":"2022101717470582900_CIT0010","doi-asserted-by":"crossref","first-page":"1590","DOI":"10.1161\/STROKEAHA.108.535245","article-title":"Carotid artery atherosclerosis, MRI indices of brain ischemia, aging, and cognitive impairment: the Framingham study","volume":"40","author":"Romero","year":"2009","journal-title":"Stroke"},{"key":"2022101717470582900_CIT0011","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1001\/archneur.1979.00500380035003","article-title":"Capsular infarcts: the underlying vascular lesions","volume":"36","author":"Fisher","year":"1979","journal-title":"Arch Neurol"},{"key":"2022101717470582900_CIT0012","doi-asserted-by":"crossref","first-page":"849","DOI":"10.1093\/oxfordjournals.aje.a009019","article-title":"Self-reported transient ischemic attack and stroke symptoms: methods and baseline prevalence. The ARIC Study, 1987-1989","volume":"144","author":"Toole","year":"1996","journal-title":"Am J Epidemiol"},{"key":"2022101717470582900_CIT0013","doi-asserted-by":"crossref","first-page":"346","DOI":"10.1212\/WNL.48.2.346","article-title":"Validation of the ACAS TIA\/stroke algorithm","volume":"48","author":"Karanjia","year":"1997","journal-title":"Neurology"},{"key":"2022101717470582900_CIT0014","doi-asserted-by":"crossref","first-page":"736","DOI":"10.1161\/01.STR.30.4.736","article-title":"Stroke incidence and survival among middle-aged adults: 9-year follow-up of the Atherosclerosis Risk in Communities (ARIC) cohort","volume":"30","author":"Rosamond","year":"1999","journal-title":"Stroke"},{"key":"2022101717470582900_CIT0015","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1111\/jon19977128","article-title":"Risk factors differ for carotid artery plaque with and without acoustic shadowing. Atherosclerosis Risk in Communities study investigators","volume":"7","author":"Duncan","year":"1997","journal-title":"J Neuroimaging"},{"key":"2022101717470582900_CIT0016","first-page":"2108","article-title":"2013 ESH\/ESC guidelines for the management of arterial hypertension","volume":"34","author":"Taylor","year":"2013","journal-title":"Eur Heart J"},{"key":"2022101717470582900_CIT0017","first-page":"1273","article-title":"Prevalence and anatomic characteristics of infarct-like lesions on MR images of middle-aged adults: the Atherosclerosis Risk in Communities study","volume":"20","author":"Bryan","year":"1999","journal-title":"AJNR Am J Neuroradiol"},{"key":"2022101717470582900_CIT0018","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1002\/sim.4780020219","article-title":"Tests for interaction in epidemiologic studies: a review and a study of power","volume":"2","author":"Greenland","year":"1983","journal-title":"Stat Med"},{"key":"2022101717470582900_CIT0019","doi-asserted-by":"crossref","first-page":"3257","DOI":"10.1161\/STROKEAHA.114.005669","article-title":"Predictors of carotid thickness and plaque progression during a decade: the Multi-Ethnic Study of Atherosclerosis","volume":"45","author":"Tattersall","year":"2014","journal-title":"Stroke"},{"key":"2022101717470582900_CIT0020","doi-asserted-by":"crossref","first-page":"1594","DOI":"10.1016\/j.jstrokecerebrovasdis.2017.02.028","article-title":"The Association between carotid artery atherosclerosis and silent brain infarction: a systematic review and meta-analysis","volume":"26","author":"Finn","year":"2017","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2022101717470582900_CIT0021","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1016\/j.jstrokecerebrovasdis.2006.08.001","article-title":"Increased intima media thickness and atherosclerotic plaques in the carotid artery as risk factors for silent brain infarcts","volume":"16","author":"Inoue","year":"2007","journal-title":"J Stroke Cerebrovasc Dis"},{"key":"2022101717470582900_CIT0022","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1212\/WNL.32.8.871","article-title":"Lacunar strokes and infarcts: a review","volume":"32","author":"Fisher","year":"1982","journal-title":"Neurology"},{"key":"2022101717470582900_CIT0023","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1136\/svn-2017-000087","article-title":"Blood pressure gradients in cerebral arteries: a clue to pathogenesis of cerebral small vessel disease","volume":"2","author":"Blanco","year":"2017","journal-title":"Stroke Vasc Neurol"},{"key":"2022101717470582900_CIT0024","doi-asserted-by":"crossref","first-page":"1368","DOI":"10.1161\/STROKEAHA.116.013193","article-title":"Silent brain infarction in patients with asymptomatic carotid artery atherosclerotic disease","volume":"47","author":"Baradaran","year":"2016","journal-title":"Stroke"}],"container-title":["American Journal of Hypertension"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/31\/8\/869\/46546406\/ajh_31_8_869.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajh\/article-pdf\/31\/8\/869\/46546406\/ajh_31_8_869.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,10,17]],"date-time":"2022-10-17T18:58:16Z","timestamp":1666033096000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajh\/article\/31\/8\/869\/4841814"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,7]]},"references-count":24,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2018,2,7]]},"published-print":{"date-parts":[[2018,7,16]]}},"URL":"https:\/\/doi.org\/10.1093\/ajh\/hpy022","relation":{},"ISSN":["0895-7061","1941-7225"],"issn-type":[{"value":"0895-7061","type":"print"},{"value":"1941-7225","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2018,8]]},"published":{"date-parts":[[2018,2,7]]}}}