Common Carotid Intima-Media Thickness in High-Risk Patients in Russia and European Populations

Background: Russia is characterized by enormously high levels of CVD mortality and morbidity as compared to European populations. A recent European study indicates the existence of a geographical gradient in subclinical atherosclerosis which parallels well the North to South geographical gradient in cardiovascular mortality described in the WHO Europe database. Aim: To compare the cIMT distribution of a selected high risk populations recruited in Moscow (n = 472) with that of the European samples described in the IMPROVE study. Patients and Methods: Asymptomatic men and women (55−79 yrs) with at least three VRFs were eligible for the Study. Different from the IMPROVE Study, ultrasonic scans were focused on the distal centimeter of common carotid arteries only. IMT measurements were performed in Monzino Cardiology Center by a qualified reader using Mat’h software. Results: The analysis carried out adding the group from Moscow to the IMPROVE study groups revealed that the correlation between the standardized mortality ratio for ischemic heart disease obtained from the WHO Europe database and cIMT is not linear (R-square 0.86, p < 0.001 for logarithmic correlation). The mean (95% CI) cIMT value was 0.82 (0.81–0.85) mm in Moscow and 0.73 (0.72–0.74) mm in Milan (p < 0.001). Conclusion: Cardiovascular mortality in Russia is only partially explained by a higher atherosclerosis risk profile; cIMT plays a role as the risk factor for atherosclerotic disease, as well as for the striking difference in cardiovascular mortality between EU and Russia.