Carotid artery intima-media thickness (IMT) is a noninvasive measurement of the artery wall thickness, inclusive of atherosclerotic plaque, obtained using ultrasound imaging. In the MESA (Multi-Ethnic Study of Atherosclerosis) study, IMT measurements are used as a surrogate for subclinical cardiovascular disease and as a variable predictive of cardiovascular events. IMT measurements of the common carotid artery are available in more than 99% of the MESA population and are predictive of cardiovascular events. More importantly, IMT and plaque thickness measurements made in the internal carotid artery and carotid bulb are also available in more than 98% of the population and are also strongly predictive of cardiovascular events. This article reviews the techniques used to obtain the MESA IMT values, compares them to those made in other epidemiological studies, and summarizes how they have been used in the MESA study as both surrogates for and predictors of cardiovascular disease.

Highlights

• A standard carotid ultrasound IMT imaging protocol was implemented at 6 clinical centers.
• Both common and internal carotid artery IMT were reliably measured in more than 98% of cases.
• Specific technical aspects affecting IMT measurements were controllable.
• Common and internal carotid IMT separately contributed to cardiovascular risk prediction.
• The MESA findings should be applicable to the general population in the United States.