Prevalence And Risk Factors Of Carotid Stenosis Among Rural Population In Tianjin-A Cross-Sectional Study

Objective:To explore the prevalence of carotid stenosis and relative determinants in low-income rural areas,a cross-sectional study was conducted across residents aged 46 and over in northern China and to give evident for intervention and prevention of carotid stenosis and stroke in rural areas.Methods:The information of general demography,lifestyle and medical condition were collected by using a well-designed questionnaire,(general demographic information include name,date of birth,gender,educated level,age;lifestyle include smoking,drinking,physical exercise;medical condition include hypertension,diabetes mellitus,dyslipidemia,stroke),interview rural residents aged over 45 by face-to-face.The height,weight,waist circumference,systolic blood pressure and diastolic blood pressure were measured by local doctors,which were trained by a professional neurologist;total cholesterol,triglycerides,high-density lipoprotein cholesterol,low-density lipoprotein cholesterol and fasting blood glucose were measured by assessing fasting venous blood.Carotid ultrasonography examination was performed by a professional imaging doctor to track the plaque and stenosis across bilateral carotid arteries.Extracranial carotid lumen stenosis ?50% was considered as CAS.The residents were separated into two groups,CAS group and NCA group,depended of imaging result.In analysis model,we compared the discrepancy between CAS and NCA across demographic information,lifestyle,medical condition,physical examination and serological result,proved the risk factors of stenosis.Stratified analysis by gender,age group,education level were conducted,in advance,to learn the distribution of risk factors of stenosis.Results:The prevalence of total CAS in this study was 6.6%,and the prevalence in male was significantly higher than in female(9.2% vs 4.4%,P<0.0001).With aging,the prevalence of CAS increased dramatically,the CAS rate was 3-folds higher in subjects aged ?70 than in <60(10.2% vs 3.1%,P<0.0001).The prevalence was 2-times higher in hypertensive patient than in normotensive subjects(7.5% vs 3.8%,P=0.001).The rate was 9.4% in hyperlipidemia,more severe than 5.8% in normolipidemic subjects(P=0.002),13.6% in stroke patients and 5.9% in stroke-free subjects(P<0.0001).Male,older age,hypertension,hyperlipidemia and stroke were risk factors for total stenosis(all P<0.05).Older age,hyperlipidemia were risk factors of CAS for both genders.Stroke,higher SBP was risk factor for male,female,respectively.The risk factors were SBP and stroke among subjects aged <60 years(all P<0.01),higher SBP and elevated LDL-C in 64-64 years(all P<0.05),male and higher TC in 65-69 years(all P?0.02),and hyperlipidemia in ? 70 years group(P=0.006).Across educational level subgroups,the factors were male,advanced age and stroke in the illiterates(all P<0.05),advanced age,hypertension and hyperlipidemia in 1~5 years(all P<0.05),advanced age,diabetes and hyperlipidemia in 6~8 years(all P<0.05),male,stroke and higher LDL-C in ?9 years(all P<0.05).Conclusion:The rate of CAS is high among the population aged ? 46 years in the low-income remote areas.CAS is closely related to male gender,older age,hypertension,hyperlipidemia and stroke.Even in multivariable analysis stratified by sex,age,and educational level,those factors were still significantly related to stenosis.Diabetes,TG,and LDL-C only shown a relationship with stenosis in a specific subgroup.To avoid the tremendous medical burden of disability and death,to intervene the development of carotid stenosis and stroke,we need to control blood pressure,blood sugar,and blood lipids actively.