Carotid artery atheromas in postmenopausal women - Their prevalence on panoramic radiographs and their relationship to atherogenic risk factors
Carotid artery atheromas in postmenopausal women - Their prevalence on panoramic radiographs and their relationship to atherogenic risk factors
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DOI：
10.14219/jada.archive.2001.0340
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发表时间：
2001-08-01
影响因子：
3.9
通讯作者：
Altman, L
中科院分区：
文献类型：
--
作者：
Friedlander, AH;Altman, L
背景资料。在美国，超过60%的中风死亡发生在绝经后的女性身上。随着雌激素水平的下降，动脉粥样硬化性病变(即动脉粥样硬化)在颈动脉分叉处发展，并被认为是大多数中风的诱因。动脉粥样硬化瘤通常是钙化的，在没有神经症状的男性退伍军人的全景X光片上已经发现；然而，类似的研究还没有在女性退伍军人中进行。作者评估了52名无神经症状的女性退伍军人(平均年龄70.4岁)的全景X线片和医疗记录，这些退伍军人有超过12个月的闭经病史，以了解动脉粥样硬化及其相关危险因素。16名受试者(31%)的X线片显示颈动脉粥样硬化位于下颌角下方和后方约2.0厘米处。所有病例的颈椎正位X线片上均有动脉粥样硬化的存在，证实了这些发现。这些受试者的病史上充斥着动脉粥样硬化的危险因素(高血压，94%)。体重指数27至29.9[超重]，25%；体重指数30或以上[肥胖]，25%；吸烟15年以上，38%；高脂血症，69%；2型糖尿病，21%)。高血压与动脉粥样硬化的存在显著相关。通过全景X线片，可以在牙科办公室识别出一些无神经症状的女性，这些女性患中风的风险很高。X光片显示颈动脉动脉钙化的女性几乎都是高血压患者，并且有大量其他致动脉粥样硬化危险因素的病史。牙医应该将这种钙化的患者转介给适当的医生进行进一步的评估和治疗。
Background. More than 60 percent of the deaths in the United States attributed to stroke occur in postmenopausal women. As estrogen levels decline, atherosclerotic lesions (that is, atheromas) develop in the region of the carotid bifurcation and have been implicated as the precipitating cause in the majority of these strokes. Atheromas often are calcified and have been detected on the panoramic radiographs of neurologically asymptomatic male veterans; however, similar studies have not been conducted among female veterans.Methods. The authors assessed panoramic radiographs and medical records of 52 neurologically asymptomatic female veterans (mean age, 70.4 years), with a history of amenorrhea of more than 12 months' duration, for atheromas and risk factors associated with atherosclerosis.Results. The radiographs of 16 subjects (31 percent) exhibited atheromas located in the neck about 2.0 centimeters inferior and posterior to the angle of the mandible. These findings were confirmed in all instances by the presence of atheromas on anteroposterior cervical spine radiographs. The medical histories of these subjects were heavily laden with atherogenic risk factors (hypertension, 94 percent. body mass index of 27 to 29.9 [characterized as overweight], 25 percent; body mass index of 30 or higher [characterized as obese], 25 percent; smoking more than 15 pack years, 38 percent; hyperlipidemia, 69 percent; type 2 diabetes mellitus, 21 percent). Hypertension was significantly associated with the presence of atheromas.Conclusions. Some neurologically asymptomatic women at high risk of developing stroke can be identified in the dental office via panoramic radiography. Women whose X-rays show calcified carotid artery atheromas are almost always hypertensive and have medical histories heavily laden with other atherogenic risk factors.Clinical Implications. Dentists should refer patients with such calcifications to an appropriate physician for further evaluation and treatment.