Carotid atherosclerosis, vascular risk profile and mortality in a population-based sample of functionally healthy elderly subjects:: the Berlin Ageing Study

被引:44
作者
Hillen, T
Nieczaj, R
Münzberg, H
Schaub, R
Borchelt, M
Steinhagen-Thiessen, E
机构
[1] Humboldt Univ, Fac Med, Evangel Geriatriezentrum Berlin, Res Grp Geriatr, Berlin, Germany
[2] Kings Coll London, Dept Publ Hlth Med, S London Community Stroke Register, London WC2R 2LS, England
[3] Ernst Moritz Arndt Univ Greifswald, Dept Psychiat & Psychotherapy, Klinikum Hansestadt Stralsund, Stralsund, Germany
关键词
carotid atherosclerosis; epidemiology; geriatrics; survival; vascular risk factor;
D O I
10.1046/j.1365-2796.2000.00681.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objectives. Studies on extracranial carotid atherosclerosis have predominately been undertaken on middle-aged subjects. This study examines the prevalence of extracranial carotid atherosclerosis, its relation to vascular risk factors and its significance for survival in elderly subjects. Design. Population-based cross-sectional survey. Non-modifiable vascular risk factors examined were family history of atherosclerotic disease, sex and apolipoprotein E (apoE) genotype. Potentially modifiable risk factors assessed were smoking, fibrinogen, fasting lipids, body mass index, hypertension and diabetes. Setting and subjects. Two hundred and twenty-five functionally healthy volunteers of the Berlin Ageing Study, aged 70-100. Main outcome measures. Presence of carotid stenosis and plaque ascertained by ultrasound imaging; 5-year mortality. Results. At least one plaque was found in 144 (64%) of the volunteers; 34 (15%) had a stenosis over 50%; and nine (4%) had a stenosis over 75%. Total cholesterol > 6.5 mmol L-1, LDL cholesterol > 4.6 mmol L-1 and total cholesterol/HDL cholesterol ratio > 5 were significantly associated with presence of plaque in 70- to 80-year-old subjects, as was diabetes in subjects over 80 years. Log-linear analyses showed significant three-way interactions for high LDL cholesterol and diabetes with plaques and age. Family history, sex, apoE genotype, smoking and fibrinogen were not related to presence of plaque in the study population. Cox regression analysis revealed increased 5-year mortality rates for subjects with plaques (OR = 2.88; 95% CI = 1.30-6.35), whereas the vascular risk profile was not associated with mortality. Conclusions. In a population-based sample of functionally healthy elderly subjects, the significance of the vascular risk profile seemed to be diminished. It had no impact on survival and only modifiable risk factors showed an age-dependent association with carotid disease.
引用
收藏
页码:679 / 688
页数:10
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