Descriptive model of carotid atherosclerosis prevalence in adult urban population of Siberian region

The aim of the study was to investigate the multifactorial associations between the traditional cardiovascular risk factors and prevalence of carotid atherosclerosis in general population of Tomsk. Cross-sectional epidemiologic study of general Tomsk population aged 25-64 years (n=1600) consisted in screening examination of extracranial carotid vascular bed to detect the presence of atherosclerotic plaques by ultrasonography. We examined age, gender, smoking exposure duration, total cholesterol, high density cholesterol, abdominal obesity, low educational status, systolic blood pressure, hsCRP, fasting plasma glucose, diabetes mellitus, antihypertensive treatment, and cholesterol-lowering treatment as potential determinants of carotid atherosclerosis. To study associations, we used logistic regression analysis. Error probability <5% was considered as statistically significant. Single-factor analysis showed that all factors were significantly associated with carotid plaque prevalence. After adjustment for age and gender, only three factors, namely: total cholesterol, smoking exposure duration, and low education were significantly associated with carotid plaques. Multiple regression analysis showed that eight factors correlated with carotid plaque prevalence in an independent manner. Among these factors, the most influential determinants of carotid plaques were age, total cholesterol, smoking exposure duration, high density cholesterol, and gender. Results of the study provide rationale for more efficacious control of target lipid profile parameters, first of all, of total cholesterol, as well as for prevention of smoking exposure to reduce prevalence of atherosclerosis in the adult urban population of Siberian region.

каротидный, атеросклероз, сонные артерии, атеросклеротические бляшки, распространенность, популяция, детерминанты, факторы риска, холестерин, липопротеиды, carotid atherosclerosis, artery, atherosclerotic plaque, prevalence, population, determinants, cholesterol, lipoproteins

1. Жернакова Ю.В., Кавешников В.С., Серебрякова В.Н. и др. Распространенность каротидного атеросклероза в неорганизованной популяции Томска // Системные гипертензии. - 2014. - Т. 11, № 4. - С. 37-42.

2. Чазова И.Е., Трубачева И.А., Жернакова Ю.В. и соавт. Распространенность артериальной гипертонии как фактора риска сердечно-сосудистых заболеваний в крупном городе Сибирского федерального округа // Системные гипертензии. - 2013. - Т. 10, № 4. - С. 30-37.

3. Шальнова С.А., Конради А.О., Карпов Ю.А. и др. Анализ смертности от сердечно-сосудистых заболеваний в 12 регионах Российской Федерации, участвующих в исследовании “Эпидемиология сердечно-сосудистых заболеваний в различных регионах России” // Российский кардиологический журнал. - 2012. - Т. 97, № 5. - С. 6-11.

4. Berger J.S., Jordan C.O., Lloyd-Jones D. Screening for cardiovascular risk in asymptomatic patients // J. Am. Coll. Cardiol. - 2010. - Vol. 55, №. 12. - P. 1169-1177.

5. Fabris F., Zanocchi M., Bo M. et al. Carotid plaque, aging, and risk factors. A study of 457 subjects // Stroke. - 1994. - Vol. 25, No. 6. - P. 1133-1140.

6. Greenland P., Alpert J.S., Beller G.A. et al. 2010 ACCF/AHA guideline for assessment of cardiovascular risk in asymptomatic adults: a report of the American College of Cardiology Foundation / American Heart Association Task Force on Practice Guidelines // J. Am. Coll. Cardiol. - 2010. - Vol. 56. - P. e50-103.

7. Ikeda N., Kogame N., Iijima R. et al. Carotid artery intima-media thickness and plaque score can predict the SYNTAX score // Eur. Heart J. - 2011. - (doi:10.1093/eurheartj/ehr399).

8. Inaba Y., Chen J.A., Bergmann S.R. Carotid plaque, compared with carotid intima-media thickness, more accurately predicts coronary artery disease events: a meta-analysis // Atherosclerosis. - 2012. - Vol. 220, No. 1. - P. 128-133.

9. Joakimsen O., Bonaa K.H., Stensland-Bugge E. et al. Age and sex differences in the distribution and ultrasound morphology of carotid atherosclerosis: The Tromso Study // Arterioscler. Thromb. Vasc. Biol. - 1999. - Vol. 19. - P. 3007-3013.

10. Johnsen S.H., Ellisiv B.M. Ultrasound imaging of carotid atherosclerosis in a normal population. The Tromso Study // Norsk. Epidemiologi. - 2009. - Vol. 19, No. 1. - P. 17-28.

11. Kerwin W.S. Carotid artery disease and stroke: assessing risk with vessel wall MRI // ISRN. Cardiology. - 2012, Nov. 14. - (ID 180710. doi: 10.5402/2012/180710.Epub).

12. Kramer C.K., von Muhlen D., Gross J.L. et al. A prospective study of abdominal obesity and coronary artery calcium progression in older adults // J. Clin. Endocrinol. Metab. - 2009. - Vol. 94, No. 12. - P.5039-5044.

13. Kuk J.L., Katzmarzyk P.T., Nichaman M.Z. et al. Visceral fat is an independent predictor of all-cause mortality in men // Obesity (Silver Spring). - 2006. - Vol. 14, No. 2. - P. 336-341.

14. Kuo F., Gardener H., Dong C. et al. Traditional cardiovascular risk factors explain the minority of the variability in carotid plaque // Stroke. - 2012. - Vol. 43, No. 7. - P. 1755-1760.

15. Lanktree M.B., Hegele R.A., Schork N.J. et al. Extremes of unexplained variation as a phenotype: an efficient approach for genome-wide association studies of cardiovascular disease // Circ. Cardiovasc. Genet. - 2010. - Vol. 3, No. 2. - P. 215-221.

16. Lee Y.H., Cui L.H., Shin M.H. et al. Associations between carotid intima-media thickness, plaque and cardiovascular risk factors [Article in Korean] // J. Prev. Med. Public. Health. - 2006. -Vol. 39, No. 6. - P. 477-484.

17. Mannami T., Konishi M., Baba S. et al. Prevalence of asymptomatic carotid atherosclerotic lesions detected by highresolution ultrasonography and its relation to cardiovascular risk factors in the general population of a japanese city. The Suita study // Stroke. - 1997. - Vol. 28. - P. 518-525.

18. Nash S.D., Cruickshanks K.J., Klein R. et al. Socioeconomic status and subclinical atherosclerosis in older adults // Prev. Med. -2011. - Vol. 52. - P. 208-212.

19. O’Leary D.H., Polak J.F., Kronmal R.A. et al. Carotid-artery intima and media thickness as a risk factor for myocardial infarction and stroke in older adults. Cardiovascular Health Study Collaborative Research Group // N. Engl. J. Med. - 1999. -Vol. 340. - P. 14-22.

20. Perk J., De Backer G., Gohlke H. et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012) // Eur. Heart J. - 2012. - Vol. 33, No. 13. - P. 1635-1701.

21. Prati P., Vanuzzo D., Casaroli M. et al. Prevalence and determinants of carotid atherosclerosis in a general population // Stroke. - 1992. - Vol. 23, No. 12. - P. 1705-1711.

22. Rundek T., Arif H., Boden-Albala B. et al. Carotid plaque, a subclinical precursor of vascular events: The Northern Manhattan study // Neurology. - 2008. - Vol. 70, No. 14. -P. 1200-1207.

23. Sillesen H., Muntendam P., Adourian A. et al. Carotid plaque burden as a measure of subclinical atherosclerosis: Comparison with other tests for subclinical arterial disease in the High Risk Plaque BioImage Study // JACC: Cardiovascular imaging. - 2012. - Vol. 5, No. 7. - P. 681-689.

24. Spence J.D., Barnett P.A., Bulman D.E. et al. An approach to ascertain probands with a non-traditional risk factor for carotid atherosclerosis // Atherosclerosis. - 1999. - Vol. 144. - No. 2. -P. 429-434.

25. Spence J.D., Eliasziw M., DiCicco M. et al. Carotid plaque area: a tool for targeting and evaluating vascular preventive therapy // Stroke. - 2002. - Vol. 33. - P. 2916-2922.

26. Willeit J., Kiechl S. Prevalence and risk factors of asymptomatic extracranial carotid artery atherosclerosis. A population-based study // Arterioscler. Thromb. - 1993. - Vol. 13, No. 5. - P. 661668.

27. Yang C., Sun Z., Li Y. et al. The correlation between serum lipid profile with carotid intima-media thickness and plaque // BMC Cardiovasc. Disord. - 2014. - Vol. 14. - P. 181.