Atherosclerosis Assessment Confounders in the Rancho

speculating on the associ-ation between the ankle-brachial index(ABI) and carotid intima-media thick-ness (IMT) in the Rancho Bernardostudy. We have a few comments thatcould add value to the work.In the carotid IMT imaging protocol,4standardizedimageswereobtainedbi-laterally from each participant: 1 at alateral angle of the common carotid ar-tery and 3 for the internal carotid artery(ICA) at the site of maximal thicknessin 3 distinct angles. Common carotidartery IMT was calculated as the meanof the left and right measurements ofthese arteries. Similarly, ICA IMT wasdetermined as the mean of the 6 ICAIMT measurements, and then the meanmaximum carotid IMT was used as theoutcome variable. However, many stud-ies have reported that mean maximumcarotid IMT is the mean of the maxi-mum thickness at 12 points