HELIUS Study: Hypertension and Smoking in Midlife Predict Carotid Plaque Composition on 3T MRI

In a multi-ethnic cohort, midlife hypertension (OR 4.02) and smoking (OR 4.94) were strongly associated with carotid plaque calcifications on 3T MRI; smoking also linked to lipid-rich necrotic core (OR 2.88). Intraplaque hemorrhage rare (3.9%).

• Longitudinal analysis of 356 participants (median age 54, 42% women) who underwent 3T carotid MRI a median of 8.4 years after cardiovascular risk factor assessment.
• Smoking independently associated with lipid-rich necrotic core (OR 2.88, 95% CI 1.30-6.40); Moroccans had lower calcification prevalence vs. Dutch, no other ethnic differences.
• Low intraplaque hemorrhage prevalence (3.9%) limited power; single-center, observational design with possible residual confounding.

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