Carotid plaque, aging, and risk factors. A study of 457 subjects.

Fabris, Fabrizio; Zanocchi, Mauro; Bo, Mario; Fonte, Gianfranco; Poli, L; Bergoglio, I; Ferrario, E.; Pernigotti, L

doi:10.1161/01.str.25.6.1133

Cited by 153 publications

(149 citation statements)

References 54 publications

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“…Our findings that traditional risk factors were associated with all 3 measures of subclinical cardiovascular disease are consistent with our previous findings in women with SLE and the findings of other studies in nonlupus populations (36)(37)(38)(39)(40)(41). These factors include older age, high blood pressure, high cholesterol, smoking, and elevated glucose and insulin levels.…”

Section: Discussionsupporting

confidence: 92%

Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus

Selzer¹,

Sutton-Tyrrell²,

Fitzgerald³

et al. 2004

Arthritis & Rheumatism

192

133

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Objective. To examine and compare risk factors for various stages of subclinical vascular disease in different vascular beds (carotid and aorta) in women with systemic lupus erythematosus (SLE) who have not yet developed clinical cardiovascular disease.Methods. This cross-sectional study was conducted in 214 women without clinical cardiovascular disease who were enrolled in the Pittsburgh Lupus Registry. B-mode ultrasound was used to measure carotid plaque and intima-media wall thickness (IMT). Doppler probes were used to collect pulse-wave velocity waveforms from the right carotid and femoral arteries as a measure of aortic stiffness. All risk factor data were collected on the day of the ultrasound examinations.Results. The mean ؎ SD age of the women was 45.2 ؎ 10.5 years and the median SLE disease duration was ϳ9 years. Sixty-eight (32%) of the women had at least 1 focal plaque. The mean ؎ SD IMT was 0.71 ؎ 0.1 mm, and the mean ؎ SD pulse-wave velocity was 5.96 ؎ 1.6 meters/second. Using logistic regression, we found that determinants of plaque included older age, higher systolic blood pressure, lower levels of high-density lipoprotein 3, and antidepressant use. Determinants of plaque severity were older age, higher systolic blood pressure, lower levels of albumin, and smoking. Independent determinants of the highest quartile of IMT were older age, higher pulse pressure, lower levels of albumin, elevated C-reactive protein levels, high cholesterol, and higher levels of glucose. Higher aortic stiffness was associated with older age, higher systolic blood pressure, higher C3 levels, lower white blood cell count, higher insulin levels, and renal disease.Conclusion. In women with SLE, the risk factors associated with carotid plaque and IMT are those typically associated with cardiovascular disease in the general population, whereas the risk factors associated with vascular stiffness include SLE-specific variables related to immune dysregulation and complement metabolism. The high prevalence of cardiovascular disease among lupus patients may result from both early adverse effects on vascular stiffening as well as later promotion of wall thickening and plaque through inflammatory-mediated processes. These observations provide clues for future mechanistic studies.Systemic lupus erythematosus (SLE) affects primarily women and causes chronic vascular inflammation. Women with SLE, particularly those under age 45 years, experience higher than expected rates of clinical cardiovascular disease, i.e., hypertension (1-3), myocardial infarction (1,4), and stroke (4). In addition to traditional cardiovascular risk factors, other factors specifically associated with SLE appear to be equally, if not more, important (5,6). It is likely that these factors are related to the underlying immune-mediated, inflammatory processes inherent in SLE.Although the pathogenesis of vascular disease in SLE is unknown, it is thought to be multifactorial and of atherosclerotic origin. Atherosclerosis involves both atherosis (fatty degeneration) an...

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Section: Discussionsupporting

confidence: 92%

Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus

Selzer¹,

Sutton-Tyrrell²,

Fitzgerald³

et al. 2004

Arthritis & Rheumatism

192

133

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show abstract

“…14 Some earlier studies have shown an association between diabetes and carotid plaques. 28,31 In the present study, the occurrence of carotid plaques tended to be higher in diabetic subjects and subjects with IGT than in subjects with NGT. The present study subjects were selected from a population-based cohort by inviting all subjects with clinical diabetes and IGT and, in addition, by selecting a normoglycaemic control subject for each diabetic subject.…”

Section: Discussionsupporting

confidence: 48%

“…33 Except for high SBP, high MBP was also associated with plaques in this study population. Apart from BP, male gender 5,12,28,30 and smoking [13][14]30 are well-established risk factors for atheromatous plaques. Carotid atherosclerosis measured by ultrasound appears to be associated with coronary artery disease 34 and to predict myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

et al. 2004

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The aim of the study was to evaluate the occurrence of atheromatous plaques in carotid, aortic and femoral arteries, focusing on blood pressure (BP). The study subjects consisted of 65-year-old Finns drawn from a population-based cohort. Ultrasonographic measurements were performed on 54 diabetic subjects, 97 subjects with impaired glucose tolerance (IGT) and 57 normoglycaemic subjects (NGT). High systolic BP (SBP) was defined as X160 mmHg and high diastolic BP as X95 mmHg. High pulse pressure (PP) was defined as the highest tertile (X75 mmHg) of PP and high mean BP (MBP) as the highest tertile (X111 mmHg) of MBP. The prevalence of atheromatous plaques was 77% (160/208) in carotid arteries, 94% (195/208) in aorta and 77% (161/ 208) in femoral arteries. A total of 64% (134/208) of the subjects had plaques in both carotid and femoral arteries, and they were compared with those who had plaques in 0-1 of these arteries. In addition to male gender and long-lasting smoking, the occurrence of plaques in both carotid and femoral arteries were associated with high SBP and high MBP. According to the results of multiple regression analyses, the adjusted odds ratio for plaques in both carotid and femoral arteries was 3.1 (95% CI 1.5-6.5) in subjects with high SBP compared to those with lower SBP. When SBP was replaced by high MBP, the adjusted odds ratio for it was 2.3 (95% CI 1.1-4.8).

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“…Table 5 Pearson's correlation and multiple linear regression analysis of atherosclerosis related factors in diabetic subjects In our study, men had significant higher carotid artery IMT than women in healthy subjects. This result corresponds to some previous studies and agree with the fact that usually men had a higher IMT than women and the incidence of coronary heart disease or stroke increases with age and is generally higher in men than in women [24,28]. However, no differences of IMT were observed between women and men in diabetic patients.…”

Section: Discussionsupporting

confidence: 92%

“…On the other hand, important decisive factors for IMT in T2DM patients are age, duration of diabetes, and LDL-cholesterol. Of all risk factors, age showed the strongest relationship with carotid atherosclerosis in both healthy subject and diabetic patients, as has also been shown in other reports [16,24].…”

Section: Discussionsupporting

confidence: 86%

Normative values of carotid artery intima-media thickness in healthy Korean adults and estimation of macrovascular diseases relative risk using this data in type 2 diabetes patients

Kim

Won

et al. 2006

Diabetes Research and Clinical Practice

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Carotid plaque, aging, and risk factors. A study of 457 subjects.

Cited by 153 publications

References 54 publications

Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus

Comparison of risk factors for vascular disease in the carotid artery and aorta in women with systemic lupus erythematosus

Blood pressure and atherosclerotic plaques in carotid, aortic and femoral arteries in elderly Finns with diabetes mellitus or impaired glucose tolerance

Normative values of carotid artery intima-media thickness in healthy Korean adults and estimation of macrovascular diseases relative risk using this data in type 2 diabetes patients

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