Clinical Research Papers:

Features and risk factors of carotid atherosclerosis in a population with high stroke incidence in China

Yanqiu Zhang, Lingling Bai, Min Shi, Hongyan Lu, Yanan Wu, Jun Tu, Jingxian Ni, Jinghua Wang, Li Cao, Ping Lei and Xianjia Ning _

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Oncotarget. 2017; 8:57477-57488. https://doi.org/10.18632/oncotarget.15415

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Yanqiu Zhang1, Lingling Bai2,3, Min Shi2,3, Hongyan Lu2, Yanan Wu2,3, Jun Tu2,3,4, Jingxian Ni2,3, Jinghua Wang2,3,4,5, Li Cao6, Ping Lei6 and Xianjia Ning2,3,4,5

1 Department of Neurology, Tianjin Nankai Hospital, Tianjin, China

2 Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China

3 Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China

4 Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China

5 Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China

6 Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China

Correspondence to:

Xianjia Ning, email:

Ping Lei, email:

Keywords: carotid intima-media thickness, carotid plaque, atherosclerosis, risk factors, epidemiology

Received: October 24, 2016 Accepted: February 06, 2017 Published: February 16, 2017


Epidemiological studies have reported associations between traditional cardiovascular risk factors and carotid intima-media thickness (CIMT) or carotid plaque. However, definite risk factors at different phases of carotid atherosclerosis remain controversial. We aimed to explore risk factors and characteristics of carotid atherosclerosis at different stages in a low-income population with a high incidence of stroke in China. Between April 2014 and January 2015, we recruited 3789 stroke-free and cardiovascular disease-free residents aged ≥ 45 years. B-mode ultrasonography was performed to measure CIMT and the presence of carotid plaque. Traditional risk factors were compared between the increased CIMT group and normal CIMT group, and between those with and without carotid plaque. A total of 3789 participants were assessed in this study, with a mean age (standard deviation) of 59.92 (9.70) years. The prevalence of increased CIMT and carotid plaque increased with older age and higher education levels. Age, hypertension, diabetes, and high low-density lipoprotein cholesterol levels were risk factors for increased CIMT and carotid plaque. Furthermore, compared to never smoking, passive smoking was positively associated with increased CIMT, with an odds ratio (95% confidence interval) of 1.26 (1.05, 1.53; P = 0.016); high body mass index was an obvious protective factor against carotid plaque, with an odds ratio (95% confidence interval) of 0.97 (0.95, 0.99; P = 0.004). It is important to identify factors associated with atherosclerosis to prevent cardiovascular disease and stroke and reduce the burden of stroke in this high-risk population.

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