Fabris F, Zanocchi M, Bo M, Fonte G, Poli L, Bergoglio I, Ferrario E, Pernigotti L
Institute of Gerontology, University of Turin, Molinette Hospital, Italy.
Stroke. 1994 Jun;25(6):1133-40. doi: 10.1161/01.str.25.6.1133.
The aim of this study was to assess the prevalence of extracranial carotid artery atherosclerosis and its relation to principal cardiovascular risk factors at different ages in a sample of the general population.
B-mode ultrasonography was used to investigate the carotid district in 457 subjects (231 men and 226 women; mean age, 55.4 +/- 18.7 years; range, 18 to 97 years) in the metropolitan area. The ultrasonographic findings were then related to risk factors.
Carotid plaques were found in 178 subjects (38.9%). The prevalence of atherosclerosis, number of plaques, and severity of stenosis were observed to increase with age. Age (P < .0001), cigarette smoking (P < .0001), male sex (P < .001), total cholesterol (P < .05), and, inversely, the ratio of high-density lipoprotein cholesterol to total cholesterol (P < .05) were found to be independently associated with carotid atherosclerosis. Stratified analysis by sex and age showed effect modifications by age on cigarette smoking, total cholesterol, and the ratio of high-density lipoprotein cholesterol to total cholesterol. After multivariate analysis including interaction terms, cigarette smoking and cholesterol levels were not longer found to be associated with carotid atherosclerosis in elderly subjects. Age (P < .01), total cholesterol (P < .05), and diabetes (P < .05) were positively related to the severity of vascular narrowing.
There is a high prevalence of asymptomatic carotid atherosclerosis in the general population, particularly among the very old. The association between risk factors and carotid atherosclerosis is less pronounced in the elderly than in younger subjects.
本研究旨在评估普通人群样本中不同年龄段颅外颈动脉粥样硬化的患病率及其与主要心血管危险因素的关系。
采用B型超声检查大城市地区457名受试者（231名男性和226名女性；平均年龄55.4±18.7岁；范围18至97岁）的颈动脉区域。然后将超声检查结果与危险因素相关联。
178名受试者（38.9%）发现有颈动脉斑块。观察到动脉粥样硬化的患病率、斑块数量和狭窄严重程度随年龄增加。年龄（P<.0001）、吸烟（P<.0001）、男性（P<.001）、总胆固醇（P<.05），以及相反地，高密度脂蛋白胆固醇与总胆固醇的比值（P<.05）被发现与颈动脉粥样硬化独立相关。按性别和年龄分层分析显示年龄对吸烟、总胆固醇和高密度脂蛋白胆固醇与总胆固醇的比值有效应修正作用。在包括交互项的多变量分析后，在老年受试者中未再发现吸烟和胆固醇水平与颈动脉粥样硬化相关。年龄（P<.01）、总胆固醇（P<.05）和糖尿病（P<.05）与血管狭窄的严重程度呈正相关。
普通人群中无症状颈动脉粥样硬化的患病率很高，尤其是在高龄人群中。危险因素与颈动脉粥样硬化之间的关联在老年人中不如在年轻受试者中明显。
