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Thank you for your interest in learning more about our latest offering at Back in Line, the Carotid Intima-Media Thickness ultrasound, or CIMT. This is just one of many steps patients can take in their quest for a deeper understanding of their overall cardiovascular health. CIMT goes along with our newly offered Integrative cardiovascular workups. You may be asking yourself, how is this different from a traditional carotid ultrasound or why is this important? We hope to answer these questions for you!

Here are some facts to support why we feel everyone would benefit from a CIMT exam at Back in Line.

1. In a study done by Sachdeva et al. looking at close to 137,000 patients hospitalized with coronary artery disease(atherosclerosis), almost half had “normal” LDL levels found on traditional lipid panels(1).
2. 1 in 4 women die from heart disease. This is more than cancer, respiratory illness, Alzheimer's disease and accidents combined(2).
3. Approximately two thirds of men and one half of women will develop cardiovascular disease after age 40(3). This statistic shows you what a large burden atherosclerosis and cardiovascular disease can have if not detected early!
4. In a study done by Willeit et al in Circulation, CIMT was found to have a high correlation with the progression of atherosclerosis and can help track therapies used to reverse its findings(7).

Anatomy of the carotid arteries

All blood vessels have two walls and the carotids are no different. They have an inner wall and an outer wall with three main layers in between. See picture 1 below. The endothelium is a single celled layer that is on the inner most aspect of the blood vessels, coming in contact with the blood. This acts as the barrier for all things entering and leaving the vessel wall, going back into circulation. The endothelium is also responsible for making nitric oxide, the main substance needed to allow vessels to relax(vasodilation). Just inside the endothelium is the intima. The intima and the middle layer, the media, is what is measured during the CIMT. The intima is where cholesterol can be deposited (atherosclerosis) first before the body makes flow limiting plaques within the vessel lumen(8). See picture 2 below.  If we can detect thickened walls, we can address this hopefully before plaques form. 

What do I do with my results, and what if they are not good?

Jill or the Back in Line front desk will reach out to you once the results are published. You will also be notified on a secure email and can view your results from home. Part of the charge for the CIMT includes a 10 minute follow up that will be scheduled when you check out after your ultrasound. The results will be discussed either in person or with a video overview-patient’s choice!

We feel that seeing is believing. If a patient is presented with findings consistent with wall thickening, signs of early atherosclerosis, have an elevated age above their actual biological age, have plaques within the carotid arteries, these findings will help mobilize positive health changes. Vasolab reports also give the patient a percentile based on age and gender. Above the 75th percentile puts a patient at high risk for cardiovascular events(5). All healthy lifestyle changes start with the basics of exercise and clean eating. Cholesterol can deposit when the endothelium is damaged. This can be from a number of things but systemic inflammation is one of the main causes. This can be from gut problems, insulin resistance and more. This would be crucial to investigate if the CIMT findings are worrisome for the individual. Advanced lipid testing, sources of inflammation, etc can be ordered by Jill Reese or Dr. CJ and obtained at the new lab drawing station at Back in Line.

Who would benefit from a CIMT?

1. Anyone around the age or soon to turn 40
2. Anyone who has been diagnosed with elevated cholesterol or is on a statin
3. Anyone with early family history of heart disease(before the age of 55)
4. Anyone who has been recommended a statin in the past but would like a second opinion to see if it is truly needed
5. Anyone with risk factors for atherosclerosis or heart disease such as diabetes, autoimmune diseases, smoker, etc.
6. Anyone curious about their vascular age and to assess if their current diet and lifestyle is benefitting their overall health
7. Males with a history of ED
8. Anyone with a history of obstructive sleep apnea

What are some things you can do to help your vascular age or CIMT measurements?

1. In our opinion, you have to fix your foundation of health before anything. This would include the American Heart Association's “Life's essential 8”: heart healthy diet, 150 minutes of moderate activity weekly, avoid smoking or second hand smoking, aim for 7-9 hours of sleep a night, aim for a healthy body weight(recommended BMI less than or equal to 25), advanced lipid testing, A1c less than 5.7 or fasting blood sugar less than 100, blood pressure below 120/80(6)
2. Supplement examples include but not limited to: high dose omega 3s, bergamot, berberine, antioxidants such as vitamin C, vitamin E, CoQ10, glutathione, etc.
3. Pharmacotherapy such as statins based on one’s risk assessment and overall health picture

Schedule your CIMT scan today!