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Turk Kardiyol Dern Ars. 2019 Jun;47(4):301-311. doi: 10.5543/tkda.2018.94770.

Age should be considered in cut-off values for increased carotid intima-media thickness.

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Department of Radiology, University of Health Sciences Adana Health Practice and Research Center, Adana, Turkey.
Department of Internal Medicine, University of Health Sciences Adana Health Practice and Research Center, Adana, Turkey.



The current guidelines use a cut-off value of 0.9 mm to define abnormally increased carotid intima-media thickness (C-IMT), regardless of age or gender. This study was conducted to examine the effects of age and gender on C-IMT and cut-off values for C-IMT in different age groups.


A total of 644 patients with a recorded C-IMT measurement, at least 1 cardiovascular risk factor, and aged between 20 and 90 years were included in the study. Common and internal C-IMT (CC-IMT and IC-IMT) measurements were obtained using carotid ultrasonography (USG). The patients were divided into 5 groups based on age: Group I (20-40 years), Group II (41-50 years), Group III (51-60 years), Group IV (61-70 years), and Group V (>70 years).


The CC-IMT and IC-IMT values were significantly greater as the age of the group increased. Group I to Group V had a median CC-IMT value of 0.70 mm, 0.70 mm, 0.75 mm, 0.75 mm, and 0.85 mm, respectively. The median IC-IMT value for each group was 0.60 mm, 0.65 mm, 0.70 mm, 0.70 mm, and 0.80 mm, respectively. The median CC-IMT value was 50 μm greater than the median IC-IMT value in all groups. Only the CC-IMT value was significantly different in males (0.80+-0.20 mm vs. 0.76+-0.19 mm; p=0.020). Age, hypertension (HT), smoking, hyperlipidemia, systolic-diastolic blood pressure, and body mass index measures were associated with increased C-IMT. Regression analysis revealed that increased C-IMT was independently associated with age and HT presence. Each decade of life and the presence of HT revealed an incidence of increased C-IMT by 44% and 53%, respectively.


C-IMT significantly increased with age. New, age-appropriate cut-off values are needed for C-IMT assessment. In addition, it was observed that the CC-IMT value was approximately 50 μm greater than the IC-IMT measurement in all age groups. CC-IMT measurements should be included in USG reports.

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