Comparative Analysis Of The Characteristics And Risk Factors Of Carotid Atherosclerosis In High-stroke-risk Population Between Urban And Rural Areas In North China

Objective:To understand the basic condition of carotid atherosclerosis and the difference of related risk factors a high-stroke-risk population in urban and rural areas of North China.This population-based study aimed to provide reliable epidemiological data for formulating of relevant policies,to intervene the main risk factors of different population groups at population level and individual level,to reduce the incidence of disease and the burden on society and family.Methods:From August 2016 to May 2017,a cross-sectional study was conducted to investigate the representative urban and rural screening sites in 12 regions of the country.Use a questionnaire to screen high-stroke-risk population who with risk factors ? 3 or with previous stroke or transient ischemic attacks(TIA).General physical examination,laboratory examination and ultrasound examination were performed on the above population.Summarize the results for a comprehensive analysis.Results:A total of 30859 patients met the screening criteria,excluding 684 incomplete subjects,and 30175 were included in the study.There were 20785 cases of high-stroke-risk population,6032 cases of stroke,3358 cases of TIA,14461 cases of urban population and 15714 cases of rural population.The presence of carotidatherosclerosis was 54.53%,that of intimal thickening was 39.22%,that of plaque was41.25% and that of stenosis was 4.05%.The detection rate of urban group is higher than that of rural group,the presence of carotid atherosclerosis was 56.47% vs 52.74,intimal thickening 42.47% vs 36.24,carotid plaque 43.77% vs 38.93,stenosis 4.61% vs 3.53%respectively.It shows that the degree of atherosclerosis in urban population is higher than that in rural population.According to the source of screening,they were divided into urban and rural.Multivariate logistic regression analysis indicated that the common independent risk factors for carotid atherosclerosis between two groups were male,age,smoking,hypertension,dyslipidemia,stroke,atrial fibrillation or valvular heart disease,systolic blood pressure(SBP),fasting blood glucose(FBG),total cholesterol(TC),low density lipoprotein cholesterol(LDL-C).Higher education,high salt consumption,passive smoking,family history of stroke,TIA as a unique independent risk factor and high density lipoprotein cholesterol(HDL)is a protective factor for carotid atherosclerosis in urban population.Conclusion:With the continuous development and progress of society and economy,people's lifestyle and eating habits have changed a lot in the past decades.The prevalence rate of traditional risk factors has changed significantly,and the degree of impact on diseases has also changed.In order to determine public health policy priorities,health changes need to be measured at different times and areas.Atherosclerosis is a comprehensive effect of multiple risk factors on long-term interaction of vascular wall.These findings revealed that sex,age,education and family history are unmodifiable risk factors,and SBP,FBG,TC,LDL-C,high salt consumption,smoking and passive smoking are controllable risk factors.At present,we still need to actively advocate changing bad lifestyle,adjusting diet structure,quitting smoking and alcohol,strengthening physical exercise,reasonably controlling blood pressure,blood glucose and blood lipid.At the same time,for the urban population,we should further strengthen the regulation ofsmoking in public space,reduce the proportion of passive smoking to reduce the occurrence of atherosclerosis,slow down its further development,and prevent the occurrence of cardiovascular disease.