Published online before print October 24, 2002, doi: 10.1161/01.STR.0000038422.57919.7F
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(Stroke. 2002;33:2929.)
© 2002 American Heart Association, Inc.
Original Contributions |
Association Between Behavior-Dependent Cardiovascular Risk Factors and Asymptomatic Carotid Atherosclerosis in a General Population
From the Institute of Epidemiology and Social Medicine (J.L., M.P., U.J.) and Department of Neurology (U.S., C.K.), Ernst-Moritz-Arndt University of Greifswald; Institute of Epidemiology and Social Medicine, University of Munster (K.B.); Institute for Social Medicine and Epidemiology, Humboldt University of Berlin (S.N.W.); and Gesellschaft für Strahlenforschung-National Research Center for Environment and Health, Neuherberg (A.D.), Germany.
Correspondence to C. Kessler, MD, Department of Neurology, Ernst-Moritz-Arndt University of Greifswald, Ellernholzstrasse 1, D-17487 Greifswald, Germany. E-mail kessler{at}neurologie.uni-greifswald.de
Background and Purpose— Physical inactivity and unfavorable dietary and lifestyle patterns are related to cardiovascular disease and premature death. Their relationship to atherosclerosis of the carotid arteries and subsequent stroke is unclear. The objective of this study was to investigate the association between those behavioral cardiovascular risk factors and asymptomatic atherosclerosis of the carotid arteries in a population of former East Germany.
Methods— The Study of Health in Pomerania (SHIP) is a cross-sectional survey in northeast Germany. In 1632 individuals aged 45 to 70 years, high-resolution B-mode ultrasound was used to assess the mean intima-media thickness of the right and left common carotid arteries. Carotid plaques and stenosis were recorded. Physical activity, dietary patterns, and cardiovascular risk factors were assessed in interviews with the use of standardized scales. Physically active participants with optimal dietary patterns were classified in the optimal lifestyle group, and those inactive with unfavorable diet were classified in the unfavorable group.
Results— After adjustment for sex and age, significant decreasing trends were found for both intima-media thickness and severe asymptomatic atherosclerosis from unfavorable to optimal lifestyle patterns in never smokers but not in smokers. Regression analysis revealed an increased risk of severe asymptomatic atherosclerosis in subjects with an unfavorable lifestyle pattern compared with those with an optimal pattern (odds ratio 2.68; 95% CI, 1.13 to 6.37), following a significant linear trend.
Conclusions— Physical activity and optimal diet are associated with reduced risk of early atherosclerosis in subjects who never smoked, while no benefit of an otherwise optimal lifestyle is observed in smokers.
Key Words: atherosclerosis • carotid artery diseases • exercise • lifestyle • ultrasonography
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