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Risk factors for atherosclerosis and aging
1Institute of Geriatric Medicine and Surgery, University of Turin, Italy.
Insights
Cardiovascular risk factors are strongly linked to atherosclerosis in younger adults but less so in individuals aged 65 and older. This study highlights age and male sex as key independent factors in older populations.
Area of Science:
- Vascular Medicine
- Gerontology
- Epidemiology
Background:
- Atherosclerosis is a significant health concern, particularly in aging populations.
- Understanding the interplay between cardiovascular risk factors and atherosclerosis is crucial for preventative strategies.
- Previous research indicates a strong association between risk factors and atherosclerosis, but this relationship may change with advanced age.
Purpose of the Study:
- To investigate the association between common cardiovascular risk factors and the presence/severity of atherosclerosis in community-dwelling older adults.
- To compare the strength of these associations in subjects under 65 versus those aged 65 and over.
Main Methods:
- Doppler ultrasound scans were employed to assess carotid and femoral atherosclerosis in 457 subjects.
- Ultrasonographic findings (plaque presence, number, and stenosis percentage) were correlated with primary cardiovascular risk factors.
- Multiple logistic regression analysis was used to identify independent risk factors within different age groups.
Main Results:
- Atherosclerosis prevalence, plaque count, and stenosis increased with age.
- Cardiovascular risk factors (age, male sex, hypertension, smoking, diabetes, hypercholesterolemia) were significantly associated with atherosclerosis in the overall cohort and those under 65.
- In subjects aged 65+, only age and male sex remained independently associated with atherosclerosis; cigarette smoking was an independent factor for femoral atherosclerosis.
Conclusions:
- While atherosclerosis increases with age, the influence of traditional cardiovascular risk factors diminishes in the elderly (65+).
- Age and male sex are the primary independent predictors of atherosclerosis in older adults.
- The findings suggest a potential shift in the etiological drivers of atherosclerosis in advanced age compared to younger individuals.
Abstract:
In order to investigate the association between atherosclerosis and risk factors in aged subjects, Doppler ultrasound scans were used to identify the presence and severity of carotid and femoral atherosclerosis in a sample of 457 community living subjects (mean age 55.4 +/- 18.7 years) of the metropolitan area; the ultrasonographic findings were then related to primary cardiovascular risk factors. Carotid and femoral plaques were found respectively in 178 (38.5%) and in 180 (39.4%) subjects. Prevalence of atherosclerosis, number of plaques and percentage of stenosis have been observed to increase with age. All the main cardiovascular risk factors (age, male sex, hypertension, cigarette smoking, diabetes and hypercholesterolemia) resulted significantly associated with both carotid and femoral atherosclerosis in the total series and, more strongly, in subjects aged under 65. On the contrary, most of these associations disappeared in subjects aged 65 or more. Multiple logistic regression analysis confirmed that in this age group only age and male sex were independently associated with carotid and femoral atherosclerosis; of the other risk factors cigarette smoking alone was an independent risk factor for femoral atherosclerosis. We conclude that in the elderly, in spite of the age-related increase in carotid and femoral atherosclerosis, the association between risk factors and atherosclerotic disease is less relevant than at younger ages.