Risk factors in young patients with peripheral atherosclerosis

Background. Risk factors and especially the combination of multiple risk fa ctors are associated with the development of atherosclerosis. Therefore, pa tients with an early manifestation of atherosclerotic disease are likely to show an extraordinary risk profile. We analysed the frequencies and severi ty of risk factors in young patients with manifest peripheral arterial occl usive disease as compared to old patients. Methods. We analysed the risk profiles in 303 patients who were sent for in terventional treatment of a symptomatic peripheral arterial occlusive disea se. The risk profiles were described for different age groups (54 patients under 50 years of age, 194 patients from 51 to 74 years, 55 patients over 7 5 years). Multiple linear regression analysis and analysis of variance were performed to look for age-dependent effects. Results. Elevated total cholesterol, and triglyceride levels and nicotine a buse were more frequent in patients younger than 50 years. Diabetes mellitu s and hypertension were more frequent in patients older than 75 years. The different frequencies for smoking, diabetes mellitus and hypertension were age-related (p<0.05). Concerning laboratory parameters such as HDL- and LDL -cholesterol, fibrinogen, lipoprotein(a) and homocysteine there were no rel evant age-related differences in frequency nor in absolute values with the exception of the hematocrit and uric acid. The coincidence with clinically manifest myocardial infarction was 11.15% in the patients under 50 years co mpared to 20.6% in those aged 51-74 years and 16.4% in those over 75 years, for cerebral stroke it was 5.6%, 17.5% and 14.5%, respectively. Patients u nder 50 years with peripheral arterial occlusive disease and a history of m yocardial infarction were characterised by high levels of total cholesterol , triglyceride and lipoprotein(a). Excluding patients with prior myocardial infarction patients did not show any difference in risk profile between th e three age groups. Conclusions. In a population suffering from manifest peripheral arterial oc clusive disease the risk profile in patients under 50 years is not differen t from that in older patients. In contrast an additional myocardial infarct ion in such a population is associated with pathological lipid profiles.