Vascular risk factors and carotid atheromatous disease in patients over 65 years of age

Main Article Content

Sónia Mateus*
Vanda Pós de Mina
Patrícia Coelho
Francisco Rodrigues
Irene Mendes

Abstract



Introduction: Vascular risk factors are decisive in the evolution of atherosclerotic disease and the carotid and vertebral Doppler ultrasound allows monitoring its onset and progress. The measurement of arterial wall thickening allows the early diagnosis of the disease enhancing its treatment and control of vascular risk factors.


Aim: Analysing the presence of atheromatous disease in individuals aged > 65 years and understanding its correlation with vascular risk factors.


Materials and methods: This is a cross-sectional observational study, in individuals aged > 65 years and underwent carotid echoDoppler between January 1, 2012, and December 31, 2021. The intimal-media index was calculated, as was the presence of atheromatous plaques, their hemodynamic repercussion and vascular risk factors were recorded.


Results: A sample of 5885 individuals was obtained with 41.8% female and 58.2% male. The mean age was 76.59 (± 6.69), with a range between 65 and 98 years. Arterial hypertension was the most prevalent 81.3%. There was a significant positive relationship between the intima-media index and age (p = 0.001). In the presence of plaques, male gender, arterial hypertension, diabetes, dyslipidemia, and smoking it presents a positive correlation.


Conclusion: In this sample, non-modifiable vascular risk factors seem to be determinants in the presence of increased arterial wall thickness. In the presence of signs of a more advanced stage of atherosclerotic disease, modifiable vascular risk factors are decisive, corroborating the already-known importance of strict control over them for their treatment.



Downloads

Download data is not yet available.

Article Details

Mateus, S., de Mina, V. P., Coelho, P., Rodrigues, F., & Mendes, I. (2023). Vascular risk factors and carotid atheromatous disease in patients over 65 years of age. Journal of Cardiovascular Medicine and Cardiology, 10(3), 035–041. https://doi.org/10.17352/2455-2976.000198
Observational Stud(y/ies)

Copyright (c) 2023 Mateus S, et al.

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.

We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.

Peertechz accomplice with- [CC BY 4.0]

Explanation

'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.

Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.

With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:

License Name

Permission to read and download

Permission to display in a repository

Permission to translate

Commercial uses of manuscript

CC BY 4.0

Yes

Yes

Yes

Yes

The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.

Cole JW. Large Artery Atherosclerotic Occlusive Disease. Continuum (Minneap Minn). 2017 Feb;23(1, Cerebrovascular Disease):133-157. doi: 10.1212/CON.0000000000000436. PMID: 28157748; PMCID: PMC5898962.

HOLMAN RL, McGILL HC Jr, STRONG JP, GEER JC. The natural history of atherosclerosis: the early aortic lesions as seen in New Orleans in the middle of the of the 20th century. Am J Pathol. 1958 Mar-Apr;34(2):209-35. PMID: 13520905; PMCID: PMC1934740.

Marques da Silva P, Lima MJ, Neves PM, Espiga de Macedo M. Prevalence of cardiovascular risk factors and other comorbidities in patients with hypertension in Portuguese primary health care populations: The PRECISE study. Rev Port Cardiol (Engl Ed). 2019 Jun;38(6):427-437. English, Portuguese. doi: 10.1016/j.repc.2018.09.011. Epub 2019 Jul 12. PMID: 31307727.

Polonia J, Martins L, Pinto F, Nazare J. Prevalence, awareness, treatment and control of hypertension and salt intake in Portugal: changes over a decade. The PHYSA study. J Hypertens. 2014 Jun;32(6):1211-21. doi: 10.1097/HJH.0000000000000162. PMID: 24675681.

Blaha MJ. The future of CV risk prediction: multisite imaging to predict multiple outcomes. JACC Cardiovasc Imaging. 2014 Oct;7(10):1054-6. doi: 10.1016/j.jcmg.2014.06.016. PMID: 25323166.

Natural history of aortic and coronary atherosclerotic lesions in youth. Findings from the PDAY Study. Pathobiological Determinants of Atherosclerosis in Youth (PDAY) Research Group. Arterioscler Thromb. 1993 Sep;13(9):1291-8. doi: 10.1161/01.atv.13.9.1291. PMID: 8364013.

Santos MG, Pegoraro M, Sandrini F, Macuco EC. Risk factors for the development of atherosclerosis in childhood and adolescence. Arq Bras Cardiol. 2008 Apr;90(4):276-283. English, Portuguese. doi: 10.1590/s0066-782x2008000400012. PMID: 18516390.

Kitamura A, Iso H, Imano H, Ohira T, Okada T, Sato S, Kiyama M, Tanigawa T, Yamagishi K, Shimamoto T. Carotid intima-media thickness and plaque characteristics as a risk factor for stroke in Japanese elderly men. Stroke. 2004 Dec;35(12):2788-94. doi: 10.1161/01.STR.0000147723.52033.9e. Epub 2004 Nov 4. PMID: 15528460.

Torres FS, Moreira CM, Vianna FF, Gus M. Intima-media thickness measurement for cardiovascular risk assessment. Rev. bras. Hypertension. 2007; 14(3) : 171-175.

O'Leary DH, Bots ML. Imaging of atherosclerosis: carotid intima-media thickness. Eur Heart J. 2010 Jul;31(14):1682-9. doi: 10.1093/eurheartj/ehq185. Epub 2010 Jun 11. PMID: 20542989.

Sousa-Uva M, Dias CM. Prevalence of stroke in the Portuguese population: data from the ECOS 2013/2014 sample.

Perdigão C, Rocha E, Duarte JS, Santos A, Macedo A. Prevalence and distribution of the main cardiovascular risk factors in Portugal--the AMALIA study. Rev Port Cardiol. 2011 Apr;30(4):393-432. English, Portuguese. PMID: 21815523.

Casella IB, Presti C, Porta RM, Sabbag CR, Bosch MA, Yamazaki Y. A practical protocol to measure common carotid artery intima-media thickness. Clinics (Sao Paulo). 2008 Aug;63(4):515-20. doi: 10.1590/s1807-59322008000400017. PMID: 18719764; PMCID: PMC2664129.

Pignoli P, Tremoli E, Poli A, Oreste P, Paoletti R. Intimal plus medial thickness of the arterial wall: a direct measurement with ultrasound imaging. Circulation. 1986 Dec;74(6):1399-406. doi: 10.1161/01.cir.74.6.1399. PMID: 3536154.

Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, Taylor DW, Haynes RB, Finan JW, Hachinski VC, Barnett HJ. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999 Sep;30(9):1751-8. doi: 10.1161/01.str.30.9.1751. PMID: 10471419.

Ferguson GG, Eliasziw M, Barr HW, Clagett GP, Barnes RW, Wallace MC, Taylor DW, Haynes RB, Finan JW, Hachinski VC, Barnett HJ. The North American Symptomatic Carotid Endarterectomy Trial : surgical results in 1415 patients. Stroke. 1999 Sep;30(9):1751-8. doi: 10.1161/01.str.30.9.1751. PMID: 10471419.

Diniz D, Correa M. The Helsinki Declaration: relativism and vulnerability. Public Health Notebooks/Ministry of Health, Oswaldo Cruz Foundation, National School of Public Health. 2001; 17(3): 679-688. https://doi.org/10.1590/s0102- 311x2001000300022.

Joakimsen O, Bonaa KH, Stensland-Bugge E, Jacobsen BK. Age and sex differences in the distribution and ultrasound morphology of carotid atherosclerosis: the Tromsø Study. Arterioscler Thromb Vasc Biol. 1999 Dec;19(12):3007-13. doi: 10.1161/01.atv.19.12.3007. PMID: 10591682.

Rodrigues AP, Kislaya I, Graff-iversen S, Silva AC, Barreto M, Gil AP. Hypertension prevalence in Portugal: results from the First National Survey with Physical Examination (INSEF 2015)/Hypertension prevalence in Portugal: results from the first Portuguese Health Examination Survey 2015. 2017; (2): 11–4. ISSN: 0874-2928. www.insa.pt.

Mariano C, Antunes M, Rato Q, Bourbon M. e_LIPID: characterization of the lipid profile of the Portuguese population. National Institute of Health Doctor Ricardo Jorge, IP - Epidemiological Bulletin Observations. 2015; 4(14): 7–10. ISSN: 2182- 88730874-2928.

Correia LG, Boavida JM, Cardoso M, Duarte JS, Duarte R, Nunes JS. Diabetes: Facts and Figures 2016, 2017, and 2018 - Annual Report of the National Diabetes Observatory. Portugal. Portuguese Society of Diabetology. 2019.

SNS. Tobacco consumption in Portugal. National Health Service. 2017. https://www.sns.gov.pt/noticias/2017/11/17/consumo-de-tabaco-em-Portugal/

Bonhorst D. A new look at the prevalence of atrial fibrillation in Portugal: The Safira study. Rev Port Cardiol (Engl Ed). 2018 Apr;37(4):315-317. English, Portuguese. doi: 10.1016/j.repc.2018.02.002. Epub 2018 Apr 22. PMID: 29685847.

Naqvi TZ, Lee MS. Carotid intima-media thickness and plaque in cardiovascular risk assessment. JACC Cardiovasc Imaging. 2014 Oct;7(10):1025-38. doi: 10.1016/j.jcmg.2013.11.014. Epub 2014 Jul 16. PMID: 25051948.

Freitas P, Piccinato CE, Martins WDP, Mauad Filho F. Carotid atherosclerosis evaluated by Doppler ultrasound: Association with risk factors and systemic arterial disease. J Vasc Bras. 2008; 7(4): 298–307. http://dx.doi.org/10.1590/S1677- 54492009005000001.

Wang X, Li W, Song F, Wang L, Fu Q, Cao S, Gan Y, Zhang W, Yue W, Yan F, Shi W, Wang X, Zhang H, Zhang H, Wang Z, Lu Z. Carotid Atherosclerosis Detected by Ultrasonography: A National Cross-Sectional Study. J Am Heart Assoc. 2018 Apr 5;7(8):e008701. doi: 10.1161/JAHA.118.008701. PMID: 29622590; PMCID: PMC6015437.

Huang LC, Lin RT, Chen CF, Chen CH, Juo SH, Lin HF. Predictors of Carotid Intima-Media Thickness and Plaque Progression in a Chinese Population. J Atheroscler Thromb. 2016 Aug 1;23(8):940-9. doi: 10.5551/jat.32177. Epub 2016 Feb 18. PMID: 26887219; PMCID: PMC7399290.

Zhang L, Fan F, Qi L, Jia J, Yang Y, Li J, Zhang Y. The association between carotid intima-media thickness and new-onset hypertension in a Chinese community-based population. BMC Cardiovasc Disord. 2019 Nov 27;19(1):269. doi: 10.1186/s12872-019-1266-1. PMID: 31775639; PMCID: PMC6882043.

Carvalho ACA de, Oliveira LS de AF, Melo DP de, Crusoé-Rebello I, Campos PSF. Development of atheromatous plaques in diabetic and hypertensive patients. Rev Medical and Biological Sciences. 2010; 9(1): 73. DOI: https://doi.org/10.9771/cmbio.v9i1.4736.

Ji X, Leng XY, Dong Y, Ma YH, Xu W, Cao XP, Hou XH, Dong Q, Tan L, Yu JT. Modifiable risk factors for carotid atherosclerosis: a meta-analysis and systematic review. Ann Transl Med. 2019 Nov;7(22):632. doi: 10.21037/atm.2019.10.115. PMID: 31930033; PMCID: PMC6944535.

Triches C, Schaan BDA, Gross JL, Azevedo MJ. Macrovascular complications of diabetes mellitus: Clinical, diagnostic and management peculiarities. Arq Bras Endocrinol Metabol. 2009; 53(6): 698–708. https://doi.org/10.1590/S0004-27302009000600002.

Amarante RDM, Castro R, Lage AV, Cisterns JR. Diabetes Mellitus as a risk factor in atherogenesis. Medical Archives of Hospitals and Faculty of Medical Sciences of Santa Casa de São Paulo. 2007; 52(3): 87–93.

Kamel H, Healey JS. Cardioembolic Stroke. Circ Res. 2017 Feb 3;120(3):514-526. doi: 10.1161/CIRCRESAHA.116.308407. PMID: 28154101; PMCID: PMC5312810.