Predictors of Carotid Intima-Media Thickness and Plaque Progression in a Chinese Population

• Main Authors: Ling-Chun Huang, 黃玲鈞
• Other Authors: Hsiu-Fen Lin
• Format: Others
• Language: en_US
• Published: 2015
• Online Access: http://ndltd.ncl.edu.tw/handle/33665616399504042797

碩士 === 高雄醫學大學 === 醫學系神經學科碩士班 === 103 === Background and Purpose Atherosclerotic diseases are the leading cause of death worldwide. Longitudinal changes in carotid intima-media thickness (IMT) and plaque are increasingly being used as markers of atherosclerosis progression and may predict future cardiovascular events. This study attempted to investigate the predictors of carotid IMT and plaque progression in a Chinese population, and to determine whether these predictors differ gender-wise. Methods Segmental-specific carotid IMT and plaque were measured in 712 stroke- and myocardial infarction-free subjects at baseline and after an average interval of 4.3±0.9 years. Multivariate linear regression and logistic regression were conducted to investigate the predictive effect of age, sex, and cardiovascular risk factors on carotid IMT and plaque progression. Sex-specific analyses were also explored. Results For overall subjects, age and smoking were predictors of common carotid artery (CCA) IMT progression (adjusted p=6.84×10-5and 0.045). Age, hypertension, and use of antihypertensive medication were predictors of bifurcation (BIF) IMT progression (adjusted p= 1.29×10-7, 0.033, 2.24×10-4 respectively). In hypertensive subjects, use of antihypertensive medication was associated with less annual IMT progression than without drugs control in all carotid artery segments, especially in the BIF. Further sex-stratified analysis showed that the predictors for IMT progression were mostly existed in women. As for plaque progression, age and sex were the independent predictors. Conclusions The present study indicates that predictors for carotid atherosclerosis progression are sex- and segmental specific. Detection and control of hypertension could preclude atherosclerosis progression, particularly in women.