Stensland-Bugge E, Bønaa K H, Joakimsen O, Njølstad I
Institute of Community Medicine, University of Tromsø (Norway).
Stroke. 2000 Mar;31(3):574-81. doi: 10.1161/01.str.31.3.574.
Ultrasound measurement of carotid artery intima-media thickness (IMT) is regarded as a valid index of atherosclerosis. Determinants of IMT in cross-sectional studies have been established, but the long-term relationship between cardiovascular risk factors and subclinical atherosclerosis has not been investigated thoroughly.
We included in the study 3128 middle-aged men and women in Tromsø, Norway, who in 1980 attended the baseline examination with measurements of cardiovascular risk factors and who underwent carotid ultrasonography after 15 years of follow-up.
Age, blood pressure, total cholesterol, HDL cholesterol, and body mass index were independent long-term predictors of IMT in both men and women. Triglyceride levels were associated with an increase in IMT in women only, while physical activity and smoking were predictors of IMT in men only. However, smoking was associated with increased risk of having atherosclerotic plaque in both men and women. There were no differences in the strength of risk factor effects on IMT in the common carotid artery and the carotid bifurcation.
The present study indicates that established cardiovascular risk factors are independent predictors of subclinical atherosclerosis measured after 15 years of follow-up. However, there may be significant sex differences in the relationship between triglycerides, smoking, and physical activity and the risk of atherosclerosis.
超声测量颈动脉内膜中层厚度（IMT）被视为动脉粥样硬化的有效指标。横断面研究中已确定了IMT的决定因素，但心血管危险因素与亚临床动脉粥样硬化之间的长期关系尚未得到充分研究。
我们纳入了挪威特罗姆瑟的3128名中年男性和女性，他们于1980年参加了基线检查，测量了心血管危险因素，并在随访15年后接受了颈动脉超声检查。
年龄、血压、总胆固醇、高密度脂蛋白胆固醇和体重指数是男性和女性IMT的独立长期预测因素。甘油三酯水平仅与女性IMT的增加有关，而体育活动和吸烟仅为男性IMT的预测因素。然而，吸烟与男性和女性患动脉粥样硬化斑块的风险增加有关。颈总动脉和颈动脉分叉处的危险因素对IMT的影响强度没有差异。
本研究表明，已确定的心血管危险因素是随访15年后测量的亚临床动脉粥样硬化的独立预测因素。然而，甘油三酯、吸烟和体育活动与动脉粥样硬化风险之间的关系可能存在显著的性别差异。
