Can Strict Control of Risk Factors Prevent Progression of Carotid Sclerosis?
Strict control of risk factors like hypertension, diabetes, dyslipidemia, and smoking cannot prevent progression of carotid atherosclerosis in patients with arteriosclerosis, according to a recent study. However, strict control can help slow disease progression.
The findings were presented on July 15, 2017, at the 22nd World Congress on Heart Disease in Vancouver, British Columbia, Canada.
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The researchers evaluated 159 patients in their study. A total of 64 patients were placed in the strict control group, and 95 were placed in the standard control group. Mean age of participants was 71.5 years in the strict control group and 72.46 years in the standard control group.
At baseline, participants in the strict control group had a systolic blood pressure (SBP) under 130 mmHg, low-density lipoprotein (LDL)-cholesterol under 80 mg/dl, and hemoglobin A1c (HbA1c) levels under 6.5%. In the standard control group, SBP was less than 140 mmHg, LDL-C was less than 140mg/dl, and HbA1c levels were less than 7%. Follow-up lasted more than 7 years.
Progression of carotid atherosclerosis was determined via ultrasonography, and carotid
plaque score (PS) and mean intima-media thickness (IMT) were calculated. The researchers also used cardio-ankle vascular index (CAVI) to assess arterial stiffness.
The researchers defined risk factors for disease progression as hypertension, diabetes mellitus, dyslipidemia and smoking.
Results showed that patients under strict control of risk factors had a mean SBP of 121.23 mmHg, a mean LDL-C of 75 mg/dl, and a mean HbA1c of 6.11%. Patients under standard control of risk factors had a mean SBP was 135.83 mmHg, a mean LDL-C was 133.95 mg/dl, and a mean HbA1c of 6.9 after standard control of risk factors.
Mean PS increased from 4.10 to 4.74 in the strict group and from 4.95 to 6.03 in standard group. Mean IMT increased from 0.94 mm to 0.91 mm in the strict group and from 0.93 mm to 0.99 mm in the standard group. In both groups, mean CAVI decreased from 9.49 to 9.30.
Through these findings, the researchers found that although strict control of risk factors may slow progression of arteriosclerosis, progression of the disease cannot be prevented.
“Even with strict control of risk factors for arteriosclerosis, progression of carotid sclerosis cannot be prevented,” the researchers concluded. “However, progression may be very slow. CAVI cannot predict progression of carotid arteriosclerosis.
—Christina Vogt
Reference:
Matsubara T, Matsubara E, Kodera S et al. Strict control of risk factors may not prevent progression of arteriosclerosis. Cardiol. 2017;137(Suppl. 1):190. doi: 10.1159/issn.0008-6312.