title: Cardiovascular risk factors are associated with subclinical atherosclerosis in high functioning older adults.
abstract: BACKGROUND
  The prevalence of subclinical atherosclerosis and its relationship with cardiovascular risk factors (CVRFs) is not well known in high functioning older adults. These data can help to decide if the implementation of preventive measures is necessary in this population.
  
  
  OBJECTIVE
  To determine the prevalence and progression of subclinical atherosclerosis in high functioning older adults, the relationship between subclinical atherosclerosis and CVRFs, and the influence of the CVRFs on subclinical atherosclerosis progression.
  
  
  METHODS
  Longitudinal cohort study. 246 high functioning older adults without clinical atherosclerotic disease. All subjects underwent carotid Doppler ultrasound at entry and 176 at 24 months.
  
  
  RESULTS
  Plaque was observed in 146 (59.3%) subjects at baseline. CVRFs showed a linear relationship to the presence of plaque: plaque was observed in 32% of subjects with no CVRFs, 54.2% with 1 factor, 61.6% with 2 factors, and 69.3% with 3 or more (p=.001). Only hypertension was independently associated with the presence of plaque (OR 2.0; 95% CI 1.2-3.6; p=.013), adjusted for CVRFs. At 24 months, new plaque was observed in 20 (11.4%) subjects and carotid intima-media thickness had increased 0.02 mm per year. Subjects with plaque at baseline had a higher risk of greater total carotid plaque diameter at 2 years (OR 58.0; 95% CI, 19.7-170.5; p<.001), adjusted for all other CVRFs.
  
  
  CONCLUSIONS
  Subclinical atherosclerosis is common in high functioning older adults and is associated with the classic CVRFs. Controlling these factors could be helpful in reducing atherosclerosis in older patients.
authors.affiliation: Geriatrics Department, Complejo Hospitalario Universitario Albacete, Spain. pabizanda@sescam.jccm.es
authors.forename: Pedro
authors.initials: P
authors.lastname: Abizanda
authors.forename: Pilar
authors.initials: P
authors.lastname: Atienzar
authors.forename: Luis
authors.initials: L
authors.lastname: Casado
authors.forename: Luis
authors.initials: L
authors.lastname: Romero
authors.forename: Pedro Manuel
authors.initials: PM
authors.lastname: Sánchez-Jurado
authors.forename: Matilde
authors.initials: M
authors.lastname: León
authors.forename: Elena
authors.initials: E
authors.lastname: Martín-Sebastiá
authors.forename: Esther
authors.initials: E
authors.lastname: López-Jiménez
authors.forename: Gema
authors.initials: G
authors.lastname: Paterna
authors.forename: Esther
authors.initials: E
authors.lastname: Martínez-Sánchez
mesh_terms: D000368:Aged; D050197:Atherosclerosis / Q000453:epidemiology / Q000209:etiology* / Q000473:pathology; D002339:Carotid Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D048909:Diabetes Complications; D018450:Disease Progression; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000150:complications; D006973:Hypertension / Q000150:complications*; D008137:Longitudinal Studies; D008297:Male; D009765:Obesity / Q000150:complications; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000473:pathology; D015995:Prevalence; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D017539:Tunica Intima / Q000000981:diagnostic imaging / Q000473:pathology*; D017540:Tunica Media / Q000000981:diagnostic imaging / Q000473:pathology*; D014463:Ultrasonography