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Risk factors in extracranial carotid disease
Insights
Patients with transient ischemic attack (TIA) or stroke showed a higher prevalence of extracranial carotid vascular disease (ECCVD). Reduced HDL cholesterol and hypertension were strongly associated with ECCVD, highlighting key risk factors.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Vascular Surgery
Background:
- Ischemic cerebrovascular disease, including transient ischemic attack (TIA) and stroke, poses a significant health burden.
- Identifying clinical and biochemical risk factors is crucial for managing patients with cerebrovascular disease.
- Extracranial carotid vascular disease (ECCVD) is a major contributor to ischemic stroke.
Purpose of the Study:
- To evaluate clinical and biochemical risk factors in patients with ischemic cerebrovascular disease.
- To assess the prevalence and significance of extracranial carotid vascular disease (ECCVD) in this patient cohort.
- To investigate the association between hypertension, lipid profiles, and ECCVD.
Main Methods:
- Prospective evaluation of 100 patients with ischemic cerebrovascular disease (67% TIA/RIND, 33% completed stroke).
- Assessment of clinical risk factors including hypertension, obesity, diabetes mellitus, and hyperuricemia.
- Utilization of Doppler scan and carotid angiography to detect extracranial carotid vascular disease (ECCVD).
- Analysis of lipid profiles, including total cholesterol and HDL cholesterol.
Main Results:
- Angiography confirmed ECCVD in 27 out of 28 patients with abnormal Doppler scans.
- Hypertension was twice as common in the ECCVD group compared to those with normal carotid vessels.
- Reduced HDL cholesterol (less than 35 mg%) was observed in 43% of patients, more frequently in the ECCVD (63%) and hypertensive (73%) groups.
- Elevated total cholesterol was found in 29% of patients.
Conclusions:
- Extracranial carotid vascular disease (ECCVD) is highly prevalent in patients with ischemic cerebrovascular events.
- Reduced HDL cholesterol and hypertension are significant risk factors associated with ECCVD.
- These findings underscore the importance of managing hypertension and lipid profiles in preventing stroke.
Abstract:
One hundred patients with ischaemic cerebro vascular disease (TIA/RIND--67% and completed stroke--33%) were evaluated for various clinical and biochemical risk factors. Evidence of extra-cranial carotid vascular disease (ECCVD) was looked for by using Doppler scan and carotid angiography. Of the 28 patients with abnormal Dop scan, 27 were confirmed to have ECCVD by angiography. Though the history of hypertension was elicited in 40%, only 28% had BP of 160/95 mm Hg or more during hospital stay. Hypertension was twice more common in ECCVD group compared to the group with normal carotid vessels. Obesity was seen in 15%, diabetes mellitus in 10% and 1% had hyperuricaemia. Total cholesterol was elevated in 29% and HDL cholesterol fraction was decreased (less than 35 mg%) in 43%. The reduction of HDL cholesterol was more frequent in ECCVD group (63%) and in hypertensive (73%) patients. Lipoproteins, triglycerides, free fatty acids and phospholipids were not significantly affected.