A Pathological Study of the Epidemiology of Atherosclerosis in Mexico City

Joel Rodríguez-Saldaña,Carlos Cantú-Brito,Jesús Aguirre-Garcia,Marcela Rodriguez-Flores

doi:10.1155/2014/264205

Abstract

Objective. To examine the frequency and patterns of association of cardiovascular risk factors with atherosclerosis in five different arterial territories at post-mortem in Mexico City. Methods. We obtained five arterial territories arteries (circle of Willis, coronary, carotid, renal, and aorta) of 185 men and women 0 to 90 years of age who underwent autopsy at the Medical Forensic Service of Mexico City. We determined the prevalence and extent of atherosclerotic lesions by histopathology according to the classification of the American Heart Association as early (types I–III) and advanced (types IV–VI), and according to the degree of stenosis and correlated with cardiovascular risk factors. Results. Atherosclerotic lesions were identified in at least one arterial territory in 181 subjects (97.8%), with involvement of two ore more territories in 178 subjects (92.2%). Advanced lesions were observed in 36% and 67% of subjects under 15 and between 16 and 35 years, respectively. Any degree of atherosclerosis was associated with the presence of diabetes mellitus, hypertension, overweight, obesity, and smoking, and to a greater extent with the presence of two or more risk factors (P < 0.001). However, emerging and advanced athersoclerosis was observed in 53% and 20% people with no risk factors. Conclusions. The study shows a high prevalence of atherosclerosis in all age groups and both sexes. There is considerable development of atherosclerotic disease in subjects without known risk factors.

Highlights

Cardiovascular disease is the main cause of disability and premature death worldwide [1] and is projected to remain the leading cause of death
In low and middle income countries, cardiovascular diseases have become an emerging issue for several reasons: [1] over 80% of the world’s deaths for CVD occur in low and middle income countries; [2] people in these countries are more exposed to risk factors leading to CVD and other noncommunicable diseases and are less exposed to prevention efforts than people in high income countries; [3] in these countries, including Mexico, people who suffer from CVD have less access to effective and equitable health care services which respond to their needs [2]
Severity of atherosclerosis and number of involved arterial territories increased with age as shown in Figures 2(a) and 2(b); the rate of atherosclerosis grades IV and V was not uncommon in young subjects: raise plaques were observed in 36% and 67% of subjects younger than 15 and 35 years old, respectively

Summary

Introduction

Cardiovascular disease is the main cause of disability and premature death worldwide [1] and is projected to remain the leading cause of death. In low and middle income countries, cardiovascular diseases have become an emerging issue for several reasons: [1] over 80% of the world’s deaths for CVD occur in low and middle income countries; [2] people in these countries are more exposed to risk factors leading to CVD and other noncommunicable diseases and are less exposed to prevention efforts than people in high income countries; [3] in these countries, including Mexico, people who suffer from CVD have less access to effective and equitable health care services which respond to their needs [2] This group of diseases greatly contributes to the rising costs of health care in the world, and a major publichealth challenge, especially for low-income countries [3]. The natural history of atherosclerosis started to be clarified from reports of postmortem studies of young men killed in the Korean and Vietnam wars [7, 8] and from the study of arterial samples of people dying from noncardiovascular

Methods

Results

Conclusion