Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.
Department of Neurology, Peking University Shougang Hospital, Beijing, 100144, China.
Sci Rep. 2020 Apr 29;10(1):7200. doi: 10.1038/s41598-020-63927-3.
In the general population, there is a strong inverse relationship between the number of ideal cardiovascular health (CVH) metrics and the total incidence of cardiovascular diseases and stroke. However, the prevalence of ideal CVH is extremely low and there are few studies on its association with newly found asymptomatic intracranial arterial stenosis (AICAS). Therefore, we performed this prospective study to assess the relationship between the newly found AICAS and ideal CVH metrics in the Chinese community population. Seven ideal CVH metrics of 3,475 participants in the Asymptomatic Polyvascular Abnormalities Community study (APAC) conducted in China (1,962 men and 1,513 women between the ages of 45 and 75 years) were collected. Based on the occurrence of newly found AICAS, all participants were divided into the AICAS group and non-ICAS group. Prevalence of ideal CVH metrics was compared between the two groups. Logistic regression was used to estimate the association of newly found AICAS with ideal CVH metrics. The result was the number of ideal CVH metrics was strongly associated with age, gender, education levels and family income (each P < 0.0001). Among the seven CVH metrics total cholesterol (TC) was the only one showing significant difference between the newly found AICAS group and non-ICAS group in our 2 years observation. Participants with less ideal CVH metrics (≤3) were associated with significantly higher prevalence of AICAS than those with more (>3) ideal CVH metrics (OR, 1.27; P = 0.045). Furthermore, less (≤3) ideal CVH metrics was markedly associated with higher incidence of AICAS for all participants, younger participants (<60 years) (OR, 1.34; P = 0.046) and men participants (OR, 1.53; P = 0.032) after adjustment for gender, age, education level, family income and stroke history. Thus we conclude that participants with newly found AICAS have high prevalence of total cholesterol status, and Individuals with low ideal CVH metrics (≤3) are associated with significantly higher prevalence of asymptomatic ICAS, especially in high-risk population of young and men participants. Therefore, primordial prevention of stroke should also focus on those high-risk populations.
在一般人群中，心血管健康（CVH）指标的数量与心血管疾病和中风的总发病率呈强烈负相关。然而，理想 CVH 的患病率极低，而且关于其与新发现的无症状颅内动脉狭窄（AICAS）的关系的研究很少。因此，我们进行了这项前瞻性研究，以评估中国社区人群中新发现的 AICAS 与理想 CVH 指标之间的关系。在中国进行的无症状多血管异常社区研究（APAC）中，共收集了 3475 名参与者的 7 项理想 CVH 指标（年龄在 45 至 75 岁之间的 1962 名男性和 1513 名女性）。根据新发现的 AICAS 的发生情况，将所有参与者分为 AICAS 组和非 AICAS 组。比较两组之间理想 CVH 指标的患病率。使用逻辑回归估计新发现的 AICAS 与理想 CVH 指标之间的关联。结果表明，理想 CVH 指标的数量与年龄、性别、教育水平和家庭收入密切相关（均 P < 0.0001）。在这 7 项 CVH 指标中，总胆固醇（TC）是我们 2 年观察中在新发现的 AICAS 组和非 AICAS 组之间唯一显示出显著差异的指标。与具有更多（>3）理想 CVH 指标的参与者相比，具有较少（≤3）理想 CVH 指标的参与者具有更高的 AICAS 患病率（比值比，1.27；P = 0.045）。此外，对于所有参与者、年龄较小（<60 岁）的参与者（比值比，1.34；P = 0.046）和男性参与者（比值比，1.53；P = 0.032），理想 CVH 指标较少（≤3）与 AICAS 的发生率显著相关，这些参与者在调整性别、年龄、教育水平、家庭收入和中风史后。因此，我们得出结论，新发现的 AICAS 患者总胆固醇水平较高，而理想 CVH 指标较低（≤3）的个体与无症状性 ICAS 的患病率显著相关，尤其是在年轻和男性参与者的高危人群中。因此，中风的一级预防也应关注这些高危人群。
