Abstract:Objective To explore the factors affecting carotid plaque formation among high-risk populations for stroke, so as to provide the reference for early intervention for carotid atherosclerosis among the populations. Methods Permanent residents were selected from Minhang District, Shanghai Municipality using the multi-staged cluster random sampling method from April to September 2021. Basic information, family history of stroke and past medical history were collected by the Community and Township Population Screening Scale for Cardiovascular and Cerebrovascular Disease Risk Factors. High-risk populations for stroke were identified according to the Technical Specifications for Stroke Screening and Prevention. Carotid plaque status was assessed using carotid ultrasonography. Factors affecting carotid plaque formation were analyzed using a multivariable logistic regression model. Results Among the 25 666 permanent residents surveyed, 8 459 were identified as high-risk populations for stroke, including 3 362 males and 5 097 females, with a male-to-female ratio of 0.66︰1. The median age was 66.00 (quartile range, 11.00) years. Carotid plaque were detected in 4 305 cases among high-risk population for stroke, accounting for 50.89%. Multivariable logistic regression analysis showed that advanced age (OR=1.052, 95%CI: 1.043-1.061), family history of stroke (OR=1.297, 95%CI: 1.103-1.526), hypertension (OR=1.245, 95%CI: 1.025-1.512) and diabetes (OR=1.439, 95%CI: 1.241-1.669) were associated with a higher risk of carotid plaque formation in male high-risk population for stroke, advanced age (OR=1.058, 95%CI: 1.051-1.066), lack of exercise (OR=1.138, 95%CI: 1.001-1.294), family history of stroke (OR=1.201, 95%CI: 1.062-1.357), significant overweight or obesity (OR=1.269, 95%CI: 1.127-1.430) and hypertension (OR=1.169, 95%CI: 1.003-1.362) were associated with a higher risk of carotid plaque formation in female high-risk population for stroke. Conclusion The main influencing factors for carotid plaque formation among high-risk populations for stroke include age, family history of stroke, exercise, significant overweight or obesity, hypertension and diabetes, with gender differences observed.
[1] IADECOLA C,BUCKWALTER M S,ANRATHER J.Immune responses to stroke:mechanisms,modulation,and therapeutic potential[J].J Clin Invest,2020,130(6):2777-2788. [2] ZHOU M G,WANG H D,ZENG X Y,et al.Mortality,morbidity,and risk factors in China and its provinces,1990-2017:a systematic analysis for the Global Burden of Disease Study 2017[J].Lancet,2019,394(10204):1145-1158. [3] KISA A,KISA S,COLLABORATORS G S.Global,regional,and national burden of stroke and its risk factors,1990-2019:a systematic analysis for the Global Burden of Disease Study 2019[J].Lancet Neurol,2021,20(10):795-820 [4] 崔柳平,周福波,潘希娟,等.血管超声评估颈动脉斑块易损性的研究进展[J].中国超声医学杂志,2024,40(3):352-355. [5] 徐寒莹,徐鹏,张影,等.中国脑卒中高危人群防控管理现状分析[J].中国慢性病预防与控制,2021,29(8):632-634. [6] SPENCE J D.Stroke prevention:a lifetime of lessons[J].Stroke,2020,51(7):2255-2262. [7] 国家卫生计生委脑卒中筛查与防治工程委员会.卒中筛查与防治技术规范[J].中华神经科杂志,2014,47(3):199-203. [8] 《中国脑卒中防治报告2021》编写组.《中国脑卒中防治报告2021》概要[J].中国脑血管病杂志,2023,20(11):783-793. [9] 陈璐,陈瑶瑶.2015—2022年永康市脑卒中发病趋势分析[J].预防医学,2024,36(1):74-77. [10] 毕媛,覃玉,苏健,等.江苏省心血管病高危人群颈动脉斑块流行及影响因素分析[J].中华流行病学杂志,2019,40(11):1432-1438. [11] 明波,何新叶,杨晓红,等.《中国心血管健康与疾病报告2023》要点解读[J].中国心血管杂志,2024,29(4):305-324. [12] CLAEYS J,GURVICH O,HADIDI N N .Association between family history of stroke and stroke risk:a community survey[J].Western J Nurs Res,2020,42(12):1174-1181. [13] SONG P G,FANG Z,WANG H Y,et al.Global and regional prevalence,burden,and risk factors for carotid atherosclerosis:a systematic review,meta-analysis,and modelling study[J].Lancet Glob Health,2020,8(5):721-729. [14] 郭雨欣,姜俊豪,曹芳,等.2019年中国脑卒中性别和年龄别疾病负担及其危险因素[J].中南大学学报(医学版),2023,48(8):1217-1224. [15] 中华医学会糖尿病学分会.中国2型糖尿病防治指南(2020年版)[J].中华糖尿病杂志,2021,13(4):315-409. [16] 赵越. 超重/肥胖与动脉粥样硬化发生的研究进展[J].公共卫生与预防医学,2024,35(1):129-132.