Does the association of risk factors and atherosclerosis change with age? - An analysis of the combined ARIC and CHS cohorts
Does the association of risk factors and atherosclerosis change with age? - An analysis of the combined ARIC and CHS cohorts
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DOI：
10.1161/01.str.28.9.1693
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发表时间：
1997-09-01
期刊：
影响因子：
8.3
通讯作者：
OLeary, DH
中科院分区：
文献类型：
--
作者：
Howard, G;Manolio, TA;OLeary, DH
在老年人群中观察到与已知疾病危险因素相关的脑血管和心血管疾病的估计相对风险降低，这可能表明老年人持续的危险因素管理可能不如年轻年龄组有效。本文在分析了现有文献的基础上，方法在社区动脉粥样硬化风险研究（ARIC）中，采用相似的方法对45 ~ 64岁的参与者进行亚临床动脉粥样硬化（通过颈动脉超声检查测量）和危险因素患病率的评估。研究和心血管健康研究（CHS）中65岁及以上的参与者。合并这两个队列提供了近19000名广泛年龄范围的参与者的危险因素和动脉粥样硬化关系的数据。回归分析被用来评估的一致性的大小的关联的危险因素与动脉粥样硬化的年龄谱分别为黑色和白色参与者在横断面analysis.Results正如预期的那样，每个危险因素是全球性的（在所有年龄）与动脉粥样硬化增加。然而，在高血压、低密度脂蛋白胆固醇（LDL-c）、纤维蛋白原或体重指数（BMI）的年龄谱中，这种关联的程度没有差异。对于白人来说，吸烟和HDL-C对老年人的影响更大，但糖尿病的影响较小。对于黑人妇女，HDL-C的影响降低之间的老年strature.Conclusions这些数据表明，大多数危险因素继续与动脉粥样硬化增加在老年人，可能表明在调查的战略，以减少动脉粥样硬化控制风险因素在老年人的持续价值。
Introduction A decrease in the estimated relative risk of cerebrovascular and cardiovascular diseases associated with known disease risk factors has been observed among elderly cohorts, perhaps suggesting that continued risk factor management in the elderly may not be as efficacious as with younger age groups. In this paper, the differential magnitude of the association of risk factors with atherosclerosis across the age spectrum from 45 years to older than 75 years is presented.Methods Subclinical atherosclerosis as measured by carotid ultrasonography and risk factor prevalence were assessed using similar methods among participants aged 45 to 64 years in the Atherosclerosis Risk in Communities (ARIC) study and among participants 65 years and older in the Cardiovascular Health Study (CHS). Pooling these two cohorts provided data on the relationship of risk factors and atherosclerosis on nearly 19 000 participants over a broad age range. Regression analyses were used to assess the consistency of the magnitude of the association of risk factors with atherosclerosis across the age spectrum separately for black and white participants in cross-sectional analyses.Results As expected, each of the risk factors was globally (across all ages) associated with increased atherosclerosis. However, the magnitude of the association did not differ across the age spectrum for hypertension, low density lipoprotein cholesterol (LDL-c), fibrinogen, or body mass index (BMI). For whites, there was a significantly greater impact of smoking and HDL-C among older age strata but a smaller impact of diabetes. For black women, the impact of HDL-C decreased among the older age strata.Conclusions These data suggest that most risk factors continue to be associated with increased atherosclerosis at older ages, possibly suggesting a continued value in investigation of strategies to reduce atherosclerosis by controlling risk factors at older ages.