OS 10-01 PREVALENCE OF CAROTID PLAQUE AND ROLE OF CARDIOVASCULAR RISK FACTORS IN A VERY ELDERLY POPULATION

Abstract

Objective: Age is considered one of the main risk factors for cardiovascular (CV) disease and aging seems to play a central role in the onset and progression of atherosclerosis. Aim: to compare the prevalence of carotid plaque in a very elderly population without history of peripheral arterial disease (PAD) and major adverse cardiovascular events (MACE), with the prevalence in a population of hypertensive adults. Design and Method: We studied 179 patients: 69 hospitalized very elderly (mean age: 88.5 ± 5.5 years) admitted to our Internal Medicine and Geriatrics Department, and 110 hypertensive adults (mean age: 53.3 ± 7.3 years) referred to our Hypertension Center, affected by essential hypertension with or without other CV risk factors (gender, smoking, diabetes, dyslipidemia). Results: There was no significant difference in the prevalence of carotid plaque between the two studied populations (51.8% in the hypertensive adults vs. 58.0% in the very elderly) despite an average difference in age of more than 35 years. In the hypertensive adults smoking was the main CV risk factor associated with the prevalence of carotid plaque (OR 2.41; p = 0.024), while in the very elderly the presence of hypertension had the strongest association (OR = 10.5; p < 0.001). Indeed, excluding the hypertensives from the very elderly population, the prevalence of carotid plaque resulted significantly higher in the younger population (51.8% vs. 27.6%; p = 0.020). Conclusions: Our results show that CV risk factors, especially hypertension, play a key role in atherosclerotic vascular disease, not only in the adult population, but also in the very elderly. Therefore aging is not necessarily synonymous with atherosclerosis but the real determinants of arterial “bad aging” are the superimposed CV risk factors. Promoting a healthy lifestyle to prevent the onset of CV risk factors and treat them appropriately whenever present, is probably the only way to obtain a healthy longevity.