Cardiovascular risk factors and atherosclerosis in young women: atherosclerosis risk factors in female youngsters (ARFY study)

Stroke. 2009 Apr;40(4):1063-9. doi: 10.1161/STROKEAHA.108.525675. Epub 2009 Feb 10.


Background and purpose: Little research has been conducted into risk factors of atherosclerosis development in young women.

Methods: This cross-sectional study enrolled 205 18- to 22-year-old female students from the Educational Centre for Allied Health Professions. A broad array of risk conditions and lifestyle behaviors was carefully assessed. Intima media thickness (IMT) was used as a well-established surrogate for atherosclerosis and a predictor of vascular risk. High IMT was defined as levels exceeding the 90th percentile in the common and/or internal carotid arteries.

Results: In multivariable logistic regression analysis, systolic blood pressure, family history for hypertension, lipoprotein(a), homocysteine, T-cell immune reaction against human heat shock protein 60, and exposure to environmental tobacco smoke and exhaust gases emerged as independent predictors of high IMT. Obesity, metabolic syndrome, and classical risk factors other than high blood pressure were rare and unrelated to IMT. Findings were similar once focusing on IMT as a continuous variable.

Conclusions: In female youngsters displaying initiating stages of vascular pathology, blood pressure level and numerous nontraditional risk conditions showed a significant relation to high IMT. Our study indicates that (auto)immune processes, high lipoprotein(a), and environmental exposure to tobacco smoke and traffic exhaust may play a role in early atherogenesis.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Air Pollutants*
  • Biomarkers / blood
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / metabolism
  • Chaperonin 60 / blood
  • Cross-Sectional Studies
  • Female
  • Humans
  • Hypertension / epidemiology*
  • Multivariate Analysis
  • Prevalence
  • Risk Factors
  • Smoking / epidemiology*
  • Ultrasonography
  • Young Adult


  • Air Pollutants
  • Biomarkers
  • Chaperonin 60