DETERMINANTS OF ATHEROSCLEROTIC PLAQUES I N THE CAROTID AND FEMORAL ARTERIES

Recent reports indicate that different regions of the arterial system vary in their susceptibility to atherogenic factors. We investigated t he association between sonographically detected plaques in the carotid and femoral arteries and established cardiovascular risk factors in a cross-sectional study of 660 men and 604 women, aged 25 to 74 years. Plaques were more common in men and here especially in the femoral art eries. The prevalence of at least one plaque increased with age. For m en, it rose in the carotids from 4,7% below 44 years to 70.7% at age 6 5-74 (women: from 5.2% to 62.4%) while in the femoral arteries increas es from 9.4% below age 44 years to 81.4% at age 65-74 were observed (w omen: 3.0% to 58.4%). Bilateral plaque involvement occurred also more frequently in the femoral than in the carotid arteries (men, 65-74 yrs .: 64.3% vs 40.7%; women, 65-74 yrs.: 36.6% vs 32.7%). In univariate c omparisons, age-adjusted fibrinogen levels were positively associated with numbers of plaques in both arterial regions for men (p <0.001) an d women (p <0.05). LDL- but not HDL-cholesterol levels showed an assoc iation with plaques in the femoral but not the carotid arteries. By co ntrast, systolic but not diastolic BP was significantly related to pla ques in the carotid (p <0.001) and much less in the femoral arteries ( p = 0.017). Smoking had a strong influence on plaque presence in both regions for men (p <0.001) while this association was weak in women (p = 0.08). Multiple logistic regression models confirmed the independen t contributions of smoking and diabetes mellitus to atherosclerosis in any of the two regions. Hypertension related to carotid, hyperlipidem ia to femoral plaque presence only. Carotid but not femoral plaques we re three times more common in men with angina symptoms than in those w ho were symptom-free. We conclude that the carotid and femoral arterie s differ substantially in terms of their susceptibility to the atherog enic effects of age, sex, and cardiovascular risk factors.