65岁以上患者的血管危险因素和颈动脉粥样硬化疾病

Mateus Sónia, de Mina Vanda Pós, Coelho Patrícia, Rodrigues Francisco, Mendes Irene
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摘要

血管危险因素在动脉粥样硬化疾病的发展中起决定性作用,颈动脉和椎体多普勒超声可以监测其发生和进展。动脉壁增厚的测量可以早期诊断疾病,加强其治疗和控制血管危险因素。目的:分析65岁以上人群动脉粥样硬化性疾病的存在及其与血管危险因素的关系。材料和方法:这是一项横断面观察性研究,研究对象为年龄> 65岁且在2012年1月1日至2021年12月31日期间接受颈动脉超声多普勒检查的患者。计算内膜-介质指数,动脉粥样硬化斑块的存在,记录其血流动力学反应和血管危险因素。结果:共获得5885人,其中女性41.8%,男性58.2%。年龄65 ~ 98岁,平均76.59(±6.69)岁。动脉高血压最为常见,占81.3%。内膜-中膜指数与年龄呈显著正相关(p = 0.001)。在存在斑块时,男性、动脉高血压、糖尿病、血脂异常和吸烟呈正相关。结论:在这个样本中,不可改变的血管危险因素似乎是动脉壁厚度增加的决定因素。在出现动脉粥样硬化疾病更晚期的迹象时,可改变的血管危险因素是决定性的,这证实了对其治疗严格控制的重要性。
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Vascular risk factors and carotid atheromatous disease in patients over 65 years of age
Introduction: Vascular risk factors are decisive in the evolution of atherosclerotic disease and the carotid and vertebral Doppler ultrasound allows monitoring its onset and progress. The measurement of arterial wall thickening allows the early diagnosis of the disease enhancing its treatment and control of vascular risk factors. Aim: Analysing the presence of atheromatous disease in individuals aged > 65 years and understanding its correlation with vascular risk factors. Materials and methods: This is a cross-sectional observational study, in individuals aged > 65 years and underwent carotid echoDoppler between January 1, 2012, and December 31, 2021. The intimal-media index was calculated, as was the presence of atheromatous plaques, their hemodynamic repercussion and vascular risk factors were recorded. Results: A sample of 5885 individuals was obtained with 41.8% female and 58.2% male. The mean age was 76.59 (± 6.69), with a range between 65 and 98 years. Arterial hypertension was the most prevalent 81.3%. There was a significant positive relationship between the intima-media index and age (p = 0.001). In the presence of plaques, male gender, arterial hypertension, diabetes, dyslipidemia, and smoking it presents a positive correlation. Conclusion: In this sample, non-modifiable vascular risk factors seem to be determinants in the presence of increased arterial wall thickness. In the presence of signs of a more advanced stage of atherosclerotic disease, modifiable vascular risk factors are decisive, corroborating the already-known importance of strict control over them for their treatment.
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