Comparison of carotid plaque burden among healthy middle-aged men living in the US, Japan, and South Korea

Abhishek Vishnu, Jina Choo, Aya Kadota, Emma J.M. Barinas-Mitchell, Akira Fujiyoshi, Dorothy Leann Long, Takashi Hisamatsu, Vasudha Ahuja, Yasuyuki Nakamura, Rhobert W. Evans, Katsuyuki Miura, Kamal H. Masaki, Chol Shin, Hirotsugu Ueshima, Akira Sekikawa

Research output: Contribution to journalArticlepeer-review

11 Citations (Scopus)


Background: Carotid plaque has emerged as a marker of coronary heart disease (CHD) risk. Comparison of carotid plaque burden between different race/ethnic groups may provide a relative estimate of their future CHD risk. Methods: We conducted a population-based study among apparently healthy middle-aged men aged 40–49 years (ERA JUMP study (n = 924)) and recruited 310 Whites in Pittsburgh, US, 313 Japanese in Otsu, Japan, and 301 Koreans in Ansan, South Korea. The number of carotid plaque and CHD risk factors was assessed using a standardized protocol across all centers. The burden of carotid plaque was compared between race/ethnic groups after adjustment for age and BMI, and after multivariable adjustment for other CHD risk factors using marginalized zero-inflated Poisson regression models. Cross-sectional associations of risk factors with plaque were examined. Results: Whites (22.8%) had more than four-fold higher prevalence (p < 0.01) of carotid plaque than Japanese men (4.8%) while the prevalence among Koreans was 10.6%. These differences remained significant after adjustment for age, BMI as well as other risk factors – incidence density ratio (95% confidence interval) for plaque was 0.13 (0.07, 0.24) for Japanese and 0.32 (0.18, 0.58) for Koreans as compared to Whites. Age, hypertension and diabetes were the only risk factors significantly associated with presence of carotid plaque in the overall population. Conclusion: Whites have significantly higher carotid plaque burden than men in Japan and Korea. Lower carotid plaque burden among Japanese and Koreans is independent of traditional CVD risk factors.

Original languageEnglish
Pages (from-to)245-249
Number of pages5
JournalInternational Journal of Cardiology
Publication statusPublished - 2018 Sept 1

Bibliographical note

Funding Information:
This work was supported by grants HL068200 , HL071561 and U54GM104942 from the National Institutes of Health , Bethesda, MD, USA, Korea Center for Disease Control and Prevention (Government budget code: 2004-E71001-00, 205-E71001-00) and grants B 16790335 , A 13307016 , 17209023 , 21249043 , A 25253046 and B 23390174 from the Japanese Ministry of Education, Culture, Sports, Science and Technology (Tokyo, Japan).

Publisher Copyright:
© 2018 Elsevier B.V.


  • Atherosclerotic plaque
  • Carotid intima-media thickness
  • Carotid stenosis
  • Epidemiology
  • Global health
  • Risk factors

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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