Prevalence and extent of atherosclerosis in adolescents and young adults - Implications for prevention from the pathobiological determinants of atherosclerosis in youth study
Prevalence and extent of atherosclerosis in adolescents and young adults - Implications for prevention from the pathobiological determinants of atherosclerosis in youth study
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DOI：
10.1001/jama.281.8.727
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发表时间：
1999-02-24
影响因子：
120.7
通讯作者：
Cornhill, JF
中科院分区：
文献类型：
--
作者：
Strong, JP;Malcom, GT;Cornhill, JF
背景：动脉粥样硬化是冠心病的根本原因，甚至在年轻人中也存在。目的记录美国青少年和年轻人动脉粥样硬化的程度和严重程度。设计和建立青年动脉粥样硬化的病理生物学决定因素在美国医学中心进行的多机构尸检研究。受试者共有2876名研究对象，年龄在15岁到34岁之间，黑人和白人，男性和女性，在1987年6月1日至1994年8月31日期间死于外部原因，并进行了尸检。主要结果衡量范围，患病率，结果最小年龄组(15~19岁)所有的主动脉和半数以上的右冠状动脉均出现内膜病变，且随着年龄的增长，病变的发生率和程度逐渐增加。黑人受试者的脂肪条纹比白人受试者更广泛，但隆起的皮损在黑人和白人中没有区别。女性和男性的主动脉隆起病变相似，但女性的右冠状动脉隆起病变比男性少。右冠状动脉病变的发生率低于主动脉，但病变占病变总数的比例右冠状动脉高于主动脉。在15至34岁的年龄范围内，脂肪条纹和临床显著隆起的皮损在患病率和范围上迅速增加。与临床表现的动脉粥样硬化疾病的初级预防不同，动脉粥样硬化的初级预防必须从儿童或青春期开始。
Context Atherosclerosis, the underlying cause of coronary heart disease, has been shown to be present even in young adults.Objective To document the extent and severity of atherosclerosis in adolescents and young adults in the United States.Design and Setting The Pathobiological Determinants of Atherosclerosis in Youth a multi-institutional autopsy study conducted in US medical centers.Subjects A total of 2876 study subjects, between 15 and 34 years old, black and white, men and women, who died of external causes and underwent autopsy between June 1, 1987, and August 31, 1994.Main Outcome Measures Extent, prevalence, and topography of atherosclerotic lesions.Results Intimal lesions appeared in all the aortas and more than half of the right coronary arteries of the youngest age group (15-19 years) and increased in prevalence and extent with age through the oldest age group (30-34 years). Fatty streaks were more extensive in black subjects than in white subjects, but raised lesions did not differ between blacks and whites. Raised lesions in the aortas of women and men were similar, but raised lesions in the right coronary arteries of women were less than those of men. The prevalence of total lesions was lower in the right coronary artery than in the aorta, but the proportion of raised lesions among total lesions was higher in the right coronary artery than in the aorta.Conclusions Atherosclerosis begins in youth. Fatty streaks and clinically significant raised lesions increase rapidly in prevalence and extent during the 15- to 34-year age span. Primary prevention of atherosclerosis, as contrasted with primary prevention of clinically manifest atherosclerotic disease, must begin in childhood or adolescence.