www.impactjournals.com/oncotarget/
Oncotarget, 2017, Vol. 8, (No. 34), pp: 57477-57488 Clinical Research Paper
Features and risk factors of carotid atherosclerosis in a population with high stroke incidence in China Yanqiu Zhang1, Lingling Bai2,3, Min Shi2,3, Hongyan Lu2, Yanan Wu2,3, Jun Tu2,3,4, Jingxian Ni2,3, Jinghua Wang2,3,4,5, Li Cao6, Ping Lei6 and Xianjia Ning2,3,4,5 1
Department of Neurology, Tianjin Nankai Hospital, Tianjin, China
2
Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
3
Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
4
Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China 5
Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
6
Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
Correspondence to: Xianjia Ning, email: [email protected] Correspondence to: Ping Lei, email: [email protected] Keywords: carotid intima-media thickness, carotid plaque, atherosclerosis, risk factors, epidemiology Received: October 24, 2016
Accepted: February 06, 2017
Published: February 16, 2017
Copyright: Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT Epidemiological studies have reported associations between traditional cardiovascular risk factors and carotid intima-media thickness (CIMT) or carotid plaque. However, definite risk factors at different phases of carotid atherosclerosis remain controversial. We aimed to explore risk factors and characteristics of carotid atherosclerosis at different stages in a low-income population with a high incidence of stroke in China. Between April 2014 and January 2015, we recruited 3789 stroke-free and cardiovascular disease-free residents aged ≥ 45 years. B-mode ultrasonography was performed to measure CIMT and the presence of carotid plaque. Traditional risk factors were compared between the increased CIMT group and normal CIMT group, and between those with and without carotid plaque. A total of 3789 participants were assessed in this study, with a mean age (standard deviation) of 59.92 (9.70) years. The prevalence of increased CIMT and carotid plaque increased with older age and higher education levels. Age, hypertension, diabetes, and high low-density lipoprotein cholesterol levels were risk factors for increased CIMT and carotid plaque. Furthermore, compared to never smoking, passive smoking was positively associated with increased CIMT, with an odds ratio (95% confidence interval) of 1.26 (1.05, 1.53; P = 0.016); high body mass index was an obvious protective factor against carotid plaque, with an odds ratio (95% confidence interval) of 0.97 (0.95, 0.99; P = 0.004). It is important to identify factors associated with atherosclerosis to prevent cardiovascular disease and stroke and reduce the burden of stroke in this high-risk population.
INTRODUCTION
income countries and in low- and middle-income countries [1]. According to 2010 statistics, stroke was the leading cause of death in rural areas and the third leading cause of death in urban areas in China [2]. Our previous studies demonstrated that the age-standardized incidence of first-ever stroke dramatically increased over the past two
Although there was no significant change in the age-standardized incidence of stroke in low-income and middle-income countries between 1990 and 2010, there was a significant reduction in mortality rates both in highwww.impactjournals.com/oncotarget
57477
Oncotarget
Table 1: Demographic characteristics of all subjects in this study Risk factors
Total
Men
Women
Total:
3789 (100)
1560 (41.2)
2229 (58.8)
Age, mean(SD), years
59.92 (9.70)
61.13 (9.90)
59.07 (9.47)
P
Oncotarget, 2017, Vol. 8, (No. 34), pp: 57477-57488 Clinical Research Paper
Features and risk factors of carotid atherosclerosis in a population with high stroke incidence in China Yanqiu Zhang1, Lingling Bai2,3, Min Shi2,3, Hongyan Lu2, Yanan Wu2,3, Jun Tu2,3,4, Jingxian Ni2,3, Jinghua Wang2,3,4,5, Li Cao6, Ping Lei6 and Xianjia Ning2,3,4,5 1
Department of Neurology, Tianjin Nankai Hospital, Tianjin, China
2
Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
3
Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
4
Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China 5
Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
6
Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
Correspondence to: Xianjia Ning, email: [email protected] Correspondence to: Ping Lei, email: [email protected] Keywords: carotid intima-media thickness, carotid plaque, atherosclerosis, risk factors, epidemiology Received: October 24, 2016
Accepted: February 06, 2017
Published: February 16, 2017
Copyright: Zhang et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License 3.0 (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
ABSTRACT Epidemiological studies have reported associations between traditional cardiovascular risk factors and carotid intima-media thickness (CIMT) or carotid plaque. However, definite risk factors at different phases of carotid atherosclerosis remain controversial. We aimed to explore risk factors and characteristics of carotid atherosclerosis at different stages in a low-income population with a high incidence of stroke in China. Between April 2014 and January 2015, we recruited 3789 stroke-free and cardiovascular disease-free residents aged ≥ 45 years. B-mode ultrasonography was performed to measure CIMT and the presence of carotid plaque. Traditional risk factors were compared between the increased CIMT group and normal CIMT group, and between those with and without carotid plaque. A total of 3789 participants were assessed in this study, with a mean age (standard deviation) of 59.92 (9.70) years. The prevalence of increased CIMT and carotid plaque increased with older age and higher education levels. Age, hypertension, diabetes, and high low-density lipoprotein cholesterol levels were risk factors for increased CIMT and carotid plaque. Furthermore, compared to never smoking, passive smoking was positively associated with increased CIMT, with an odds ratio (95% confidence interval) of 1.26 (1.05, 1.53; P = 0.016); high body mass index was an obvious protective factor against carotid plaque, with an odds ratio (95% confidence interval) of 0.97 (0.95, 0.99; P = 0.004). It is important to identify factors associated with atherosclerosis to prevent cardiovascular disease and stroke and reduce the burden of stroke in this high-risk population.
INTRODUCTION
income countries and in low- and middle-income countries [1]. According to 2010 statistics, stroke was the leading cause of death in rural areas and the third leading cause of death in urban areas in China [2]. Our previous studies demonstrated that the age-standardized incidence of first-ever stroke dramatically increased over the past two
Although there was no significant change in the age-standardized incidence of stroke in low-income and middle-income countries between 1990 and 2010, there was a significant reduction in mortality rates both in highwww.impactjournals.com/oncotarget
57477
Oncotarget
Table 1: Demographic characteristics of all subjects in this study Risk factors
Total
Men
Women
Total:
3789 (100)
1560 (41.2)
2229 (58.8)
Age, mean(SD), years
59.92 (9.70)
61.13 (9.90)
59.07 (9.47)
P
