The trends in development of aortic and coronary atherosclerosis in healthy male population were studied by WHO methods in three trials: in 1963-1965, 1985-1987, 2001-2003. It was found that atherosclerosis and coronary arteries stenosis were less frequent in the native population of Yakutia than in migrants.
In a cross-sectional autopsy study of 107 Inuit in Greenland, the extent of arterial surface involvement with atherosclerosis was evaluated in the presence of known or estimated environmental risk factors for coronary heart disease (CHD): age, gender, obesity, serum lipids, smoking, and hypertension. Mean, median, and range values for all of the risk factor variables and for the extent of atherosclerosis in the thoracic aorta, abdominal aorta, right coronary artery, and left anterior descending coronary artery are reported by age strata, along with the results of covariant analysis of the dependence of the extent of atherosclerosis upon the risk factors. No significant differences between females and males were found in either the risk factors or prevalence and extent of atherosclerosis in the aorta and in the coronary arteries. It appears that the extent of advanced atherosclerotic lesions in Greenlanders appears to be the same as that previously reported in a similar study in Alaska Natives.
Fatty streak was always present in both the thoracic aorta and the abdominal aorta in the youngest subjects studied (aged 10-14 years). Fibrous plaque was present in a small proportion of these young subjects, but a rapid increase in prevalence occurred as early as the fourth decade. Complicated and calcified lesions appeared as early as the age of 20-25 years but a rapid increase in prevalence was seen after age 40 for complicated lesions and after age 50 for calcified lesions. There were differences in the prevalence of severe lesions among the five towns. There was little increase in the extent of atherosclerosis in the thoracic aorta before the age of 40 and in the abdominal aorta before the age of 20. The increase was more rapid after those ages. When atherosclerosis had affected about 50% of the intimal surface of the thoracic aorta and 70% of the intimal surface of the abdominal aorta, the increase slowed down considerably. In contrast to other types of lesion, the extent of fatty streak increased only up to 30 years of age, when it occupied 25-30% of the intimal surface. Then it declined and in the older age groups did not exceed 4-5% in men or women. The extent of fibrous plaque and complicated lesions was at all ages greater in men than in women, while the extent of fatty streak and calcified lesions in older age groups was greater in women. There were marked differences in the extent of atherosclerotic lesions in the five towns.
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Atherosclerotic disease in the femoral artery in hypertensive patients at high cardiovascular risk. The value of ultrasonographic assessment of intima-media thickness and plaque occurrence. Risk Intervention Study (RIS) Group.
The aim of the present investigation was to examine the occurrence of ultrasound-assessed morphological changes in the right common femoral artery and relate these findings to the ankle-arm index and to symptoms of lower-extremity arterial disease in hypertensive men at high cardiovascular risk (n = 143). Comparisons were made with a healthy reference group consisting of age-matched men at low risk (n = 46). The results showed that it was possible to obtain high-quality measurements of intima-media thickness in about 80% of all men and that the intraobserver variability was satisfactory (14%). A normal mean intima-media thickness was defined, using data from the low-risk group. Plaque occurrence and mean intima-media thickness in the right common femoral artery were significantly associated with ankle-arm index both in the right and left leg. There were more and larger plaques, as well as thicker mean and maximum intima-media complexes, in the high-risk group than in the low-risk group. In the high-risk group, 11% suffered from symptoms of right lower-extremity artery disease, 20% had an ankle-arm index
The trends in atherosclerosis presentation were followed up pathomorphologically in a two-stage epidemiological survey performed in 9 cities of CIC and Baltic states at 25-year interval. The investigations were conducted in accordance with WHO program. Stage 1 (1963-1968) covered 6121 cases, stage 2 (1985-1989) included 9201 cases. The material was collected on the condition of aortas and coronary arteries from 20-59-year-old males who were residents of the cities of Irkutsk, Yakutsk, Tallin, Tartu, Riga, Kharkov, Yalta, Ashkhabad, Bishkek. The 2-stage examinations gave evidence for growing severity of atherosclerosis. Risk factor analysis demonstrated an increase in the percentage of males with diabetes mellitus and arterial hypertension, in the percentage of overweight males and of those with atherosclerosis engaged in mental work. It is found that atherosclerosis undergoes changes within the life of one generation (for 20-25 years).