Background: Serum bilirubin is negatively associated with the development of coronary heart disease. In the present study, we have focused on the analysis of intima-media thickness (IMT) of the common carotid artery in hyper- and normobilirubinemic subjects. Methods: The study was performed on 111 men without manifested atherosclerosis. In all subjects, complete biochemical tests were determined along with the examination of IMT by carotid ultrasound. Results: The mean IMT in hyperbilirubinemic subjects as compared with controls was substantially lower (p = 0.017), and hyperbilirubinemic men also had very low age-adjusted prevalence odds ratios for having IMT above the 50th percentiles of controls, even after adjustment for selected vascular risk factors (p = 0.034). Conclusions: In the present study, we demonstrate the inverse relationship between serum bilirubin and IMT in healthy men.

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