• Erwin Chiquete, Juan José Gómez-Piña, Guillermo Ramírez-García, Eduardo Ruiz-Ruiz, José Domingo Barrientos-Guerra, Liz Toapanta-Yanchapaxi, José Alejandro Flórez-Cardona, Fernando Flores-Silva, Isael Reyes-Melo, Guillermo García-Ramos, Jesús Higuera-Calleja, and Carlos Cantú-Brito.
• Instituto Nacional de Ciencias Médicas y de la Nutrición "Salvador Zubirán", Departamento de Neurología y Psiquiatría, Ciudad de México, México.
• Gac Med Mex. 2019 Jan 1; 155 (4): 350-356.

IntroductionAtherosclerotic carotid artery disease (CAD) is a major risk factor for cerebrovascular disease.ObjectiveTo analyze the association of major vascular risk factors with atherosclerotic CAD and white matter disease (WMD) in patients without a history of ischemic stroke.MethodRisk factors were assessed with carotid examination using Doppler duplex ultrasound. Cases with a history cerebral infarction or transient ischemic attack were not included. Subjects had brain magnetic resonance imaging scans available and those with large-artery ischemic lesions were excluded. Multivariate models were constructed for the prediction of atherosclerotic CAD, significant carotid stenosis, atheroma burden and WMD.ResultsOne-hundred and forty-five subjects were assessed (60.7% were females, mean age was 73 years). Atherosclerotic CAD was documented in 54.5%, carotid stenosis ≥ 50% in 9.0%, > 6 atheroma plaques in 7.6%, and periventricular or subcortical WMD in 28.3% (20.6% had atherosclerotic CAD and WMD concurrently). Risk factors independently associated with atherosclerotic CAD were age and hypertension; hypertension was associated with ≥ 50% carotid stenosis; age was associated with > 6 atheroma plaques; and age, diabetes and hypertension were associated with WMD. Obesity was not associated with any of the analyzed independent variables.ConclusionsIn asymptomatic subjects without a history of ischemic stroke, age and hypertension were the most important risk factors for macrovascular disease. Diabetes mellitus was associated with microvascular disease. Obesity alone was not a major determinant of CAD or WMD.Copyright: © 2019 Permanyer.

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