Key result
The overall incidence of carotid atherosclerosis was 12.20% (14.10% in men vs 9.20% in women, p<0.0001), with decision tree analysis identifying total cholesterol and fasting plasma glucose as the most important risk factors for men and women under 60, respectively.
Cross-Sectional (n=4,910)
No
Absolute Event Rate: 14.1% vs 9.2%
p-value: p=<0.0001
Traditional risk factors and their relevant cutpoints for carotid atherosclerosis differ significantly by gender and age group, suggesting that prevention strategies should be tailored accordingly.
Sex- and age-specific risk factor patterns for carotid atherosclerosis were identified; hypothesis-generating and should not yet change practice.
BACKGROUND: Reducing the exposure to risk factors for the prevention of cardio-cerebral vascular disease is a crucial issue. Few reports have described practical interventions for preventing cardiovascular disease in different genders and age groups, particularly detailed and specific cutpoint-based prevention strategies. METHODS: We collected the health examination data of 5822 subjects between 20 and 80 years of age. The administration of medical questionnaires and physical examinations and the measurement of blood pressure, fasting plasma glucose (FPG) and blood lipids [total cholesterol (TC), triglycerides (TG), high density lipoprotein-cholesterol (HDL-C), and low density lipoprotein-cholesterol (LDL-C)] were performed by physicians. Carotid ultrasound was performed to examine the carotid intima-media thickness (CIMT), which was defined as carotid atherosclerosis when CIMT ≥0.9 mm. Decision tree analysis was used to screen for the most important risk factors for carotid atherosclerosis and to identify the relevant cutpoints. RESULTS: In the study population, the incidence of carotid atherosclerosis was 12.20% (men: 14.10%, women: 9.20%). The statistical analysis showed significant differences in carotid atherosclerosis incidence between different genders (P<0.0001) and age groups (P<0.001). The decision tree analysis showed that in men, the most important traditional risk factors for carotid atherosclerosis were TC (cutpoint [CP]: 6.31 mmol/L) between the ages of 20-40 and FPG (CP: 5.79 mmol/L) between the ages of 41-59. By comparison, LDL-C (CP: 4.27 mmol/L) became the major risk factor when FPG ≤5.79 mmol/L. FPG (CP: 5.52 mmol/L) and TG (CP: 1.51 mmol/L) were the most important traditional risk factors for women between 20-40 and 41-59 years of age, respectively. CONCLUSION: Traditional risk factors and relevant cutpoints were not identical in different genders and age groups. A specific gender and age group-based cutpoint strategy might contribute to preventing cardiovascular disease.
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Qin et al. (2014) conducted a cross-sectional in Carotid atherosclerosis (n=4,910). Traditional risk factors (e.g., total cholesterol, fasting plasma glucose) vs. Unexposed/reference groups was evaluated on Incidence of carotid atherosclerosis (CIMT ≥0.9 mm) (p=<0.0001). The overall incidence of carotid atherosclerosis was 12.20% (14.10% in men vs 9.20% in women, p<0.0001), with decision tree analysis identifying total cholesterol and fasting plasma glucose as the most important risk factors for men and women under 60, respectively.
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