ABSTRACT NUMBER: ESOC2026A1300 EXPLORING THE INTERPLAY BETWEEN CARDIOVASCULAR RISK FACTORS AND CAROTID HEMODYNAMICS: THE ROTTERDAM STUDY

Abstract Background and aims Cardiovascular risk factors (CVRFs) and arterial wall shear stress (WSS) are both linked to atherosclerosis, yet their relationship remains underexplored. This study aims to investigate associations between CVRFs and carotid hemodynamics, including WSS and flow, in a population-based setting. Methods The mean and 95th percentile WSS were determined from steady-state computational fluid dynamics simulations for 2322 carotid arteries of 1314 participants of the Rotterdam Study (mean age 71 years, 45.3% female). CVRFs including hypertension, smoking status, dyslipidemia, diabetes mellitus, and obesity were assessed, with missingness handled through multiple imputation. Associations between CVRFs and carotid hemodynamics were assessed using multivariable mixed models, with all CVRFs entered simultaneously and adjusted for age and sex. Results Higher common carotid inlet flow was observed in males, whereas older age, obesity and diabetes mellitus were independently associated with lower flow. Older age and obesity were also associated with lower WSS in both the common and internal carotid artery. However, despite their higher flow, males showed lower WSS in the common carotid artery. Furthermore, dyslipidemia was independently associated with higher WSS in the common carotid artery. Conclusions Our findings show that multiple CVRFs are linked to hemodynamics in the carotid arteries, with obesity, diabetes mellitus and dyslipidemia showing significant effects. In males, we observed higher carotid inlet flow but lower WSS compared to females, highlighting that WSS is influenced by other determinants beyond flow alone. These insights contribute to a deeper understanding of the complex interplay between CVRFs, carotid hemodynamics and atherosclerosis. Conflict of interest S.C.M. van Kuijk: nothing to disclose. A. Akyildiz: nothing to disclose. J.J. Wentzel: nothing to disclose. M.K. Ikram: nothing to disclose. D. Bos: nothing to disclose.