Summary: Mean (±SE) intima–media thickness adjusted for age, sex, height, and racial or ethnic group was increased by 80±19 µm (95 percent confidence interval, 43 to 116; P<0.001) among carriers of two variant alleles, as compared with carriers of the common (wild-type) allele. In multivariate analysis, the increase in intima–media thickness among carriers of two variant alleles (62 µm, P<0.001) was similar in this cohort to that associated with diabetes (64 µm, P=0.01), the strongest common cardiovascular risk factor. Increased intima–media thickness was significantly associated with intake of both arachidonic acid (P for trend <0.001) and linoleic acid (P for trend=0.03) among carriers of two variant alleles but not among carriers of the common. In contrast, the intake of marine n-3 fatty acids was significantly and inversely associated with intima–media thickness only among carriers of two variant alleles (P for trend=0.007). Finally, the plasma level of C-reactive protein, a marker of inflammation, was increased by a factor of 2 among carriers of two variant alleles as compared with that among carriers of the common allele.