Sustained progression and loss of the gender-related difference in atherosclerosis in the very old: a pathological study of 1074 consecutive autopsy cases.
BACKGROUND
Epidemiological surveys show decrease or reversal of male predominance in cardiovascular mortality in the very old, but the actual condition of atherosclerosis in the very old is largely unknown. The objective of this paper is to reveal whether the atherosclerosis continues to progress, or the gender-related difference exists in the very old.


METHODS
The subjects were 1074 consecutive autopsy cases of in-hospital death. The male:female ratio was 1.1:1 and the average age was 80 years. Macroscopic evaluation was performed on the degree of atherosclerosis in 10 arteries including the intracranial arteries, carotid artery, aorta, coronary artery, and femoral artery.


RESULTS
The severity of atherosclerosis differed greatly among arteries. The age-related increase of the atherosclerotic degree was evident, even after 80 years of age. The atherosclerosis was more severe in males than in females in their 60s, but this male predominance decreased with ageing and finally disappeared in their 90s.


CONCLUSIONS
The sustained progression of atherosclerosis and loss of the gender-related difference probably account for the increase of cardiovascular mortality in very old females. They also suggest that the prevention of the atherosclerotic progression is still important in the seventh and eighth decade of life.
Sawabe
Motoji
M
Department of Pathology, Tokyo Metropolitan Geriatric Hospital, 35-2 Sakae-cho, Itabashi, Tokyo 173-0015, Japan. sawabe@tmig.or.jp
Arai
Tomio
T
Kasahara
Ichiro
I
Hamamatsu
Akihiko
A
Esaki
Yukiyoshi
Y
Nakahara
Ken-ichi
K
Harada
Kazumasa
K
Chida
Kouji
K
Yamanouchi
Hiroshi
H
Ozawa
Toshio
T
Takubo
Kaiyo
K
Murayama
Shigeo
S
Tanaka
Noriko
N
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000473:pathology; D050197:Atherosclerosis / Q000453:epidemiology* / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology; D001344:Autopsy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012727:Sex Characteristics