New risk factors in The Atherosclerosis Risk In Communities Study

Background. Although a number of cardiovascular (CVD) risk factors have been firmly established, several putative risk factors require further investigation of their role in CVD. Methods. The Atherosclerosis Risk in Communities (ARIC) Study has examined several potential "new" risk factors in relation to carotid intima-media thickness (a subclinical marker of atherosclerosis) and to incident coronary heart disease (CHD) in a population-based sample. Results. ARIC data have implicated fibrinogen, lipoprotein(a), and cellular adhesion molecules as markers of, or risk factors for, CVD. Fibrinolytic factors and platelet activation were associated with carotid atherosclerosis, but we do not yet have data for their associations with incident CHD. Notably, we do not find strong evidence that homocysteine or prior infection with Chlamydia pneumoniae or CMV are risk factors for incident CHD, though they were weakly associated with prevalent carotid atherosclerosis. The role of serum insulin as a CHD risk factor remains uncertain, given an association for women but not men in ARIC, and inconsistency in the literature. Conclusions. The ARIC Study provides prospective evidence related to several potential new risk factors for CHD.