[Association between carotid lesions evaluated by Doppler color echocardiography and cardiovascular risk factors in
F Binaghi1, P F Fronteddu, V Putzu
1Istituto di Clinica Medica, Università degli Studi, Cagliari.
Insights
In older adults, diffuse intima-media thickening (IMT) exceeding 0.75 mm in carotid arteries indicates arterial aging, not a cardiovascular risk factor. Cholesterol levels correlate with lesion severity in men.
Area of Science:
- Geriatric Medicine
- Cardiovascular Health
- Diagnostic Imaging
Background:
- Cerebral ictus prevention in the elderly is crucial.
- Echo color-Doppler assessment of extracranial carotids is vital for geriatric stroke prevention.
- This study differentiates age-related arterial changes from atherosclerotic disease in older adults.
Purpose of the Study:
- To distinguish carotid lesions due to atherosclerosis from age-related arterial wall changes in individuals over 65.
- To investigate the relationship between carotid lesions and cardiovascular risk factors in an elderly population.
Main Methods:
- Echo color-Doppler analysis of carotid arteries in 50 elderly subjects.
- Classification of carotid lesions by severity based on hemodynamic standards.
- Correlation analysis with cardiovascular risk factors: hypercholesterolemia, hypertension, overweight, and smoking.
Main Results:
- Diffuse intima-media thickening (IMT) > 0.75 mm was present in all subjects.
- Atherosclerotic plaques were found in 39 subjects, with only 4 at risk for cerebral ischemia.
- Significant correlation between lesion severity and total/LDL cholesterol in males; a trend was observed for smoking.
Conclusions:
- Diffuse IMT > 0.75 mm in older subjects should be considered a marker of carotid arterial aging.
- This finding contrasts with its classification as a cardiovascular risk factor in middle-aged individuals.
- Distinguishing aging from disease is key for accurate risk assessment in the elderly.
Background:
The valuation of the extracranial carotid by echo color-Doppler takes on an extraordinary importance for the prevention of cerebral ictus at geriatric age. In this "naturalistic" study a population of old people (> 65 yrs) of Cagliari's province was considered in order to: 1) discriminate the lesions of the carotid that are imputed to atherosclerotic disease by anatomic changes of the arterial wall caused by aging; 2) study relations between lesions of the carotid and cardiovascular risk factors.
Methods:
The carotids of 50 old subjects were studied by echo color-Doppler and the lesion classified in different classes of severity, according to the hemodynamic standard, comparing them with the presence of the most important cardiovascular risk factors. Hypercholesterolemia was the most frequent risk factor (76%), followed by hypertension (62%), over-weight (54%) and smoking (42%). Moreover a diffused intima-media thickening (IMT) was constant in all the subjects with values > 0.75 mm; athero-sclerotic plaques were even present in 39 subjects which only in 4 cases could be considered at risk of cerebral ischemia.
Results:
A significant correlation between the severity of the lesions and levels of total cholesterol and LDL cholesterol for the male sex emerged, while for smoking only a trend of correlation has been obtained.
Conclusions:
Considering this experience it is suggested that in old subjects the presence of a diffused IMT with values > 0.75 mm must be considered as a marker of aging of the arterial wall of the carotid and not as a cardiovascular risk factor as reported in the literature for the middleaged.
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