Carotid intima-media thickness: studies into methodological aspects

Carotid artery intima-media thickness (CIMT) is widely used in observational and intervention studies. Despite the long history and its frequent use there is little uniformity in the measurement of CIMT. This diversity may have substantial effects on published results of studies and on the interpretation thereof. In this thesis we aimed to study several methodological aspects of CIMT measurements to facilitate an evidence-based decision making with respect to CIMT measurements. In chapter 2, two online techniques to measure CIMT, an automated RF approach and a manual B-mode approach, were compared. CIMT measured with B-mode showed stronger relations with established risk factors and was more strongly associated with risk of future cardiovascular events whereas in individuals with a thin CIMT (