Related Experiment Videos
Risk factors for extracranial carotid artery atherosclerosis
J R Crouse1, J F Toole, W M McKinney
1Department of Medicine, Wake Forest University Medical Center, Bowman Gray School of Medicine, Winston-Salem, N.C. 27103.
Insights
This study links common risk factors and coronary artery disease to the severity of carotid atherosclerosis. Shared risk factors explain some of this association, suggesting common underlying causes for both conditions.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Epidemiology
Background:
- Carotid atherosclerosis and coronary artery disease often coexist.
- Understanding shared risk factors is crucial for cardiovascular health.
- Extracranial carotid atherosclerosis extent can be measured non-invasively.
Purpose of the Study:
- To investigate the relationship between traditional cardiovascular risk factors, symptoms, and coronary status with extracranial carotid atherosclerosis.
- To identify predictors of carotid atherosclerosis extent.
- To explore shared etiological factors between coronary and carotid atherosclerosis.
Main Methods:
- B-mode ultrasonography was used to measure carotid atherosclerosis in 376 volunteers undergoing coronary angiography.
- Multivariate regression analyses were performed to identify significant risk factors.
- Coronary status (stenosis presence/absence) was incorporated in a second analysis.
Main Results:
- Age, hypertension, smoking (pack-years), low high-density lipoprotein cholesterol, low uric acid, and Framingham Type A score significantly predicted carotid atherosclerosis extent (35% variability explained).
- Coronary status added an additional 5% to the explained variability of carotid atherosclerosis.
- A graded relationship was observed between continuous risk factors and carotid atherosclerosis in both sexes.
Conclusions:
- Shared risk factors contribute significantly to the association between coronary and carotid atherosclerosis.
- The findings support the concept of common underlying factors influencing both arterial beds.
- Unexplained variability suggests the role of undiscovered risk factors or genetic predispositions.
Abstract:
We related risk factors, cardiovascular symptoms, and coronary status to the extent of extracranial carotid atherosclerosis as measured by B-mode ultrasonography in 376 volunteers hospitalized for elective coronary angiography. In a first analysis, we correlated risk factors and cardiovascular symptoms with carotid atherosclerosis. Univariate analysis showed that relations between many continuous risk factors and carotid atherosclerosis were graded and consistent for men and women. Multivariate analysis identified 6 significant variables (age, hypertension, pack-years smoked, and inversely, plasma concentrations of high density lipoprotein cholesterol and uric acid, and Framingham Type A score) that together accounted for 35% of the variability in extent of carotid atherosclerosis. In a second multivariate analysis, addition of coronary status (presence or absence of coronary stenosis as evaluated by coronary angiography) to the roster of candidate independent variables produced a new equation that accounted for an additional 5% of the variability in carotid atherosclerosis extent. Although much of the variability in extent of carotid atherosclerosis remains unexplained, these data define an association between coronary and carotid atherosclerosis that depends partly on shared exposure of both arteries to the same risk factors. They are also consistent with the concept that as yet undiscovered risk factors and/or genetic (e.g., arterial wall) factors common to both arterial beds also contribute to the relation between coronary and carotid atherosclerosis in human beings.