Willeit J, Kiechl S
Department of Neurology, University Clinic Innsbruck, Austria.
Arterioscler Thromb. 1993 May;13(5):661-8. doi: 10.1161/01.atv.13.5.661.
To evaluate the prevalence and risk factors of asymptomatic carotid artery disease, we analyzed a sample of 909 men and women (aged 40-79 years) drawn from the community-based Bruneck Ischemic Heart Disease and Stroke Prevention Study. For the four decades of age (40-49, 50-59, 60-69, and 70-79 years), respective prevalence rates as assessed by duplex scanning were found to be 8.2%, 39.7%, 66.4%, and 82.5% in men and 3.3%, 22.3%, 48.7%, and 76.7% in women. High-grade stenosis (> 80%) classified by Doppler criteria was twice as frequent in men (2.4%) as in women (1.1%). Age and sex were found to be particularly strong and independent predictors of asymptomatic carotid artery disease. Accordingly, separate logistic regression models were developed for both men and women in the elderly (65-79 years) and middle-aged (50-64 years) groups. Systolic blood pressure turned out to be the only attribute with independent significance in all subgroups examined. Cigarette smoking, recorded as pack-years, emerged as the leading risk factor of carotid atherosclerosis in men. Serum fibrinogen levels were found to be highly indicative of carotid artery disease in elderly men and women. For apolipoprotein B predictive significance was observed in the middle-aged populations, whereas apolipoprotein A-I had a protective effect in elderly women. Diabetes mellitus completed the risk factor profile for elderly men. In summary, the relation between cardiovascular risk factors and asymptomatic carotid artery disease showed a dynamic dependence on sex and age. These findings may help to improve the efficacy of risk prediction in the general population and facilitate well-directed preventive measures.
为评估无症状性颈动脉疾病的患病率及危险因素，我们分析了从基于社区的布伦内克缺血性心脏病和中风预防研究中抽取的909名年龄在40 - 79岁之间的男性和女性样本。对于4个十年年龄段（40 - 49岁、50 - 59岁、60 - 69岁和70 - 79岁），经双功超声扫描评估，男性的患病率分别为8.2%、39.7%、66.4%和82.5%，女性分别为3.3%、22.3%、48.7%和76.7%。根据多普勒标准分类的重度狭窄（> 80%）在男性中的发生率（2.4%）是女性（1.1%）的两倍。年龄和性别被发现是无症状性颈动脉疾病特别强有力且独立的预测因素。因此，针对老年（65 - 79岁）和中年（50 - 64岁）组的男性和女性分别建立了逻辑回归模型。收缩压在所有检查的亚组中被证明是唯一具有独立意义的属性。以吸烟包年数记录的吸烟成为男性颈动脉粥样硬化的主要危险因素。血清纤维蛋白原水平在老年男性和女性中被发现高度提示颈动脉疾病。载脂蛋白B在中年人群中具有预测意义，而载脂蛋白A - I在老年女性中具有保护作用。糖尿病完善了老年男性的危险因素谱。总之，心血管危险因素与无症状性颈动脉疾病之间的关系显示出对性别和年龄的动态依赖性。这些发现可能有助于提高一般人群中风险预测的有效性，并促进有针对性的预防措施。
