Xi Ji1,2, Xin-Yi Leng3, Yi Dong4, Ya-Hui Ma1, Wei Xu5, Xi-Peng Cao6, Xiao-He Hou5, Qiang Dong4, Lan Tan1,5, Jin-Tai Yu4. 1. Department of Neurology, Qingdao Municipal Hospital, Dalian Medical University, Dalian 116044, China. 2. Department of Neurology, Xuchang People's Hospital, Xuchang 461000, China. 3. Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China. 4. Department of Neurology and Institute of Neurology, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China. 5. Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China. 6. Clinical Research Center, Qingdao Municipal Hospital, Qingdao University, Qingdao 266071, China.
Abstract
BACKGROUND: Carotid atherosclerosis is a major cause of stroke, but the conclusion about risk factors for carotid atherosclerosis is still controversial. The aim of our present meta-analysis and systematic review was to explore the modifiable risk factors for carotid atherosclerosis. METHODS: We searched PubMed from January 1962 to October 2018 to include longitudinal and cross-sectional studies. The results were pooled using random effects model. Heterogeneity was measured by I2 statistic and publication bias was assessed by funnel plots. RESULTS: A total of 14,700 articles were screened, of which 76 with 27 factors were eligible. Our meta-analysis of cross-sectional studies indicated nine factors (hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, hypertriglyceridemia, diabetes, and higher low density lipoprotein) were significantly associated with the presence of carotid plaque, among which four (hyperlipidemia, hyperhomocysteinemia, hypertension, and hyperuricemia) could elevate the risk of atherosclerosis by at least 50%; and one factor (hypertension) was associated with increased carotid intima-media thickness. In the systematic review, another five factors [negative emotion, socioeconomic strain, alcohol, air pollution, and obstructive sleep apnea syndrome (OSAS)] were also related to the presence of atherosclerosis. The cross-sectional associations with most of the above 14 factors were further confirmed by longitudinal studies. Among them, the managements of 4 factors (hypertension, hyperlipidemia, diabetes and OSAS) were indicated to prevent carotid atherosclerosis by cohort studies. CONCLUSIONS: Effective interventions targeting pre-existing disease, negative emotion, lifestyle and diet may reduce the risk of carotid atherosclerosis. Further good-quality prospective studies are needed to confirm these findings. 2019 Annals of Translational Medicine. All rights reserved.
BACKGROUND: Carotid atherosclerosis is a major cause of stroke, but the conclusion about risk factors for carotid atherosclerosis is still controversial. The aim of our present meta-analysis and systematic review was to explore the modifiable risk factors for carotid atherosclerosis. METHODS: We searched PubMed from January 1962 to October 2018 to include longitudinal and cross-sectional studies. The results were pooled using random effects model. Heterogeneity was measured by I2 statistic and publication bias was assessed by funnel plots. RESULTS: A total of 14,700 articles were screened, of which 76 with 27 factors were eligible. Our meta-analysis of cross-sectional studies indicated nine factors (hyperlipidemia, hyperhomocysteinemia, hypertension, hyperuricemia, smoking, metabolic syndrome, hypertriglyceridemia, diabetes, and higher low density lipoprotein) were significantly associated with the presence of carotid plaque, among which four (hyperlipidemia, hyperhomocysteinemia, hypertension, and hyperuricemia) could elevate the risk of atherosclerosis by at least 50%; and one factor (hypertension) was associated with increased carotid intima-media thickness. In the systematic review, another five factors [negative emotion, socioeconomic strain, alcohol, air pollution, and obstructive sleep apnea syndrome (OSAS)] were also related to the presence of atherosclerosis. The cross-sectional associations with most of the above 14 factors were further confirmed by longitudinal studies. Among them, the managements of 4 factors (hypertension, hyperlipidemia, diabetes and OSAS) were indicated to prevent carotid atherosclerosis by cohort studies. CONCLUSIONS: Effective interventions targeting pre-existing disease, negative emotion, lifestyle and diet may reduce the risk of carotid atherosclerosis. Further good-quality prospective studies are needed to confirm these findings. 2019 Annals of Translational Medicine. All rights reserved.
Authors: S Paterniti; M Zureik; P Ducimetière; P J Touboul; J M Fève; A Alpérovitch Journal: Arterioscler Thromb Vasc Biol Date: 2001-01 Impact factor: 8.311
Authors: Marijn C Meuwese; Eric de Groot; Raphaël Duivenvoorden; Mieke D Trip; Leiv Ose; Frans J Maritz; Dick C G Basart; John J P Kastelein; Rafik Habib; Michael H Davidson; Aeilko H Zwinderman; Lee R Schwocho; Evan A Stein Journal: JAMA Date: 2009-03-18 Impact factor: 56.272
Authors: M L Bots; M K Palmer; S Dogan; Y Plantinga; J S Raichlen; G W Evans; D H O'Leary; D E Grobbee; J R Crouse Journal: J Intern Med Date: 2009-03-02 Impact factor: 8.989
Authors: Sara Alsulaimani; Hannah Gardener; Mitchell S V Elkind; Ken Cheung; Ralph L Sacco; Tatjana Rundek Journal: Stroke Date: 2013-01-03 Impact factor: 7.914
Authors: Matthew S Painschab; Victor G Davila-Roman; Robert H Gilman; Angel D Vasquez-Villar; Suzanne L Pollard; Robert A Wise; J Jaime Miranda; William Checkley Journal: Heart Date: 2013-04-25 Impact factor: 5.994
Authors: Shohreh F Farzan; Rima Habre; Phoebe Danza; Frederick Lurmann; W James Gauderman; Edward Avol; Theresa Bastain; Howard N Hodis; Carrie Breton Journal: Environ Health Date: 2021-04-14 Impact factor: 5.984
Authors: Yunpeng Lin; Yan Li; Zhiying Li; Zhen Zhang; Jie Liu; Jiayi Sun; Jun Tu; Jinghua Wang; Wenjuan Zhang; Jidong Li; Xianjia Ning Journal: Int J Womens Health Date: 2022-06-16