Atherosclerosis without Risk Factors

A study revealed that many middle-aged individuals free of cardiovascular risk factors (CVRF) have atherosclerosis. Atherosclerosis presence and extent was associated with low-density lipoprotein cholesterol (LDL-C) and glycosylated hemoglobin levels (HbA1c). The study evaluated 1,779 (45.0 ± 4.1 years old, 50.3% women) participants. CVRF freedom was defined as no current smoking and untreated blood pressure <140/90 mm Hg, fasting glucose <126 mg/dl, total cholesterol <240 mg/dl, LDL-C <160 mg/dl, and high-density lipoprotein cholesterol ≥40 mg/dl. A subgroup with optimal CVRFs (n = 740) was also defined as having blood pressure <120/80 mm Hg, fasting glucose <100 mg/dl, HbA1c <5.7%, and total cholesterol <200 mg/dl. Subclinical atherosclerosis (carotid, iliofemoral, and abdominal aortic plaques or coronary artery calcification) was present in 49.7% of CVRF-free participants. In addition to male sex and age, LDL-C was independently associated with atherosclerosis presence and extent, in both the CVRF-free and CVRF-optimal groups (odds ratio [×10 mg/dl]: 1.14 to 1.18). Atherosclerosis presence and extent was also associated in the CVRF-free group with glycosylated hemoglobin levels. The findings are consistent with previous studies. The findings suggest that additional factors are involved in atherogenesis; while LDL-C may play critical role, slightly increased HbA1c levels are linked to atherosclerosis, particularly in combination with other risk factors in atherogenesis. Source: http://www.onlinejacc.org/