Prevalence and severity of atherosclerosis in different arterial territories and its relation with obesity
Marcela Rodríguez-Flores1, Joel Rodríguez-Saldaña, Carlos Cantú-Brito
1Obesity and Eating Disorders Clinic, Instituto Nacional de Ciencias Médicas y Nutrición "Salvador Zubirán," SS. Vasco de Quiroga No. 15. Colonia Sección XVI. Tlalpan, Mexico City, Mexico, PC 14000.
Insights
Coronary arteries show the most severe atherosclerosis, independent of obesity. While higher body mass index correlates with advanced lesions, it is not an independent risk factor after accounting for other variables.
Area of Science:
- Cardiovascular pathology
- Atherosclerosis research
- Public health
Background:
- The relationship between obesity, cardiovascular risk factors, and events is inconsistent.
- Atherosclerosis severity varies across arterial territories.
- This study investigates obesity and risk factors in atherosclerosis.
Purpose of the Study:
- To analyze the association between cardiovascular risk factors, including obesity, and atherosclerosis severity.
- To compare atherosclerosis severity across five arterial territories.
- To identify independent risk factors for advanced atherosclerotic lesions.
Main Methods:
- Histopathological analysis of arteries from 185 autopsied individuals (newborn to 90 years).
- Arterial territories examined: circle of Willis, carotids, coronaries, aorta, and renal.
- Atherosclerotic lesions classified as early (types I-III) or advanced (types IV-VI) per AHA grading.
Main Results:
- Advanced lesions were most frequent in coronary arteries (right: 71%, left: 85%) and aorta (52%).
- Increasing body mass index (BMI) showed a higher risk for advanced lesions (P=.004).
- BMI was not independently associated with advanced lesions after adjusting for age, gender, smoking, hypertension, and diabetes.
Conclusions:
- Coronary arteries are disproportionately affected by atherosclerosis, suggesting local and systemic factor influence.
- Obesity (BMI) was not found to be an independent predictor of advanced atherosclerotic lesions.
- Findings highlight the complex interplay of factors in atherosclerosis development across different vascular beds.
Background:
There is uneven association between obesity, traditional risk factors, and cardiovascular events. We aimed to analyze the relation between cardiovascular risk factors, including obesity, with the severity of atherosclerosis in different arterial territories.
Methods:
Arteries from five territories (circle of Willis, carotids, coronaries, aorta, and renal) were taken from 185 persons, newborn to 90 years undergoing autopsy in the Forensic Medical Service in Mexico City, to determine atherosclerotic lesions by histopathological study. Lesions were classified according to the American Heart Association grading system as early (types I-III) and advanced (types IV-VI). The degree of atherosclerosis was correlated with arterial territories and risk factors.
Results:
Frequencies of advanced lesions according to arterial territories were as follows: circle of Willis, 28%; right carotid, 36%; left carotid, 25%; right coronary, 71%; left coronary, 85%; right renal, 26%; left renal, 29%; and aorta, 52%; P=.0001, for all analyses. There was a higher risk for advanced lesions with increasing body mass index (BMI) (P=.004). However, after adjusting for age, gender, smoking status, hypertension, and diabetes mellitus, BMI was not independently associated with advanced lesions.
Conclusions:
Coronary arteries are significantly more affected than other arterial territories regardless of risk factors, showing the effect of local and systemic factors in the severity of atherosclerosis. We did not find an independent association between advanced atherosclerotic lesions and obesity.
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