All vascular ultrasound evaluations were performed by the same blinded assessor (GK). Subclinical atherosclerosis was assessed by the presence of plaques in a total of eight arterial beds (left and right, common and internal, carotid arteries and carotid bulb, and both common femoral arteries) by ultrasound. Atherosclerotic plaques were defined as the local increase of the intima–media thickness (IMT) of >50% compared with the surrounding vessel wall, an IMT of >1.5 mm or local thickening of >0.5 mm.25 (link) Progression of atherosclerosis was defined as either (1) new appearance of plaques in individuals without plaques at baseline or (2) increase in number of plaques in individuals who already had plaques at the same carotid or femoral artery. Measurements were performed using high-resolution B-mode ultrasound (Vivid 7 Pro, GE Healthcare) with a 12 MHz linear matrix array transducer.