Carotid atherosclerosis and contributing factors in a population at high risk of stroke

Abstract

Objective To investigate the occurrence of carotid atherosclerosis in a population of permanent residents (age ≥40 years) at high risk of stroke in Xuejiadao Street, Huangdao District, Qingdao City, and to provide a scientific basis for reduction of carotid atherosclerosis in high-risk communities. Methods Using a cluster sampling method, 10 007 permanent residents of age ≥40 years were enrolled in the study. Based on data from an early population screening project, 1 478 subjects at high risk of carotid atherosclerosis and stroke were included for analysis. These study subjects were divided into a carotid atherosclerosis risk group and a normal group. General data were recorded, and the results of a physical examination and clinical and biochemical tests were used to analyze risk factors. Results Of 1 478 high-risk subjects aged (58.8±9.7) years, 726 had normal arteries. Of these, 264 (36.36%) were males and 462 (63.64%) were females. Carotid atherosclerosis was identified in 752 cases aged (61.4±9.5) years, with a detection rate of 50.88%. Of these, 390 were males (51.86%) and 362 were females (48.14%). Univariate analysis showed that age, male sex, history of heart disease, diabetes, or hypertension, smoking, alcohol intake, waist circumference, and elevated homocysteine and low-density lipoprotein cholesterol levels were positively correlated with carotid atherosclerosis in those at high risk of stroke, while physical exercise showed a negative correlation; these results were statistically significant (P<0.05). Multiple logistic regression analysis [OR (95%CI)] showed that age [1.621 (1.410-1.865)], male sex [0.474 (0.378-0.594)], history of heart disease [1.336 (1.085-1.645)], diabetes [1.312 (1.021-1.685)], or hypertension [1.408 (1.074-1.846)], and increased low-density lipoprotein cholesterol [1.444 (1.191-1.751)] were positively correlated with carotid atherosclerosis in those at high risk of stroke, while physical exercise [0.810 (0.690-0.950)] showed a negative correlation; these results were statistically significant (P<0.05). Conclusion Targeting elderly men at high risk of stroke for intervention and guidance to manage hypertension, diabetes, and other chronic diseases, as well as comprehensive preventive and control measures, including reasonable physical exercise, can effectively reduce the occurrence of carotid atherosclerosis in communities. Key words: Stroke; Carotid atherosclerosis; High-risk group; Contributory factors