Intima–media thickness

[1] Ultrasound measurements of carotid IMT were first proposed and validated in vitro by Paolo Pignoli in 1984[2] and further details were subsequently published in a highly cited article.

[3] The use of IMT as a non-invasive tool to track changes in arterial walls has increased substantially since the mid-1990s.

[8] However, in 2003 the European Society of Hypertension–European Society of Cardiology guidelines for the management of arterial hypertension[9] recommended the use of carotid IMT measurements in high-risk patients to help identify target organ damage and in 2010 the American Heart Association and the American College of Cardiology advocated the use of carotid IMT on intermediate risk patients if usual risk classification was not satisfactory.

[16] Carotid IMT has been used in many epidemiological and clinical studies and these have shown associations with several risk factors, including type 2 diabetes,[17] familial hypercholesterolemia,[18] high-density lipoprotein cholesterol (HDL-C), triglycerides,[19] rheumatoid arthritis,[20] non-alcoholic fatty liver disease,[21] and air pollution.

[22] Since the 1990s, some clinical trials of lifestyle and pharmaceutical interventions have also used carotid artery IMT as a surrogate endpoint for evaluating the regression and/or progression of atherosclerotic cardiovascular disease;[23] however the appropriateness of carotid IMT in this context is uncertain.