Factors related to carotid atherosclerosis based on different blood pressure levels in adult population

Abstract OBJECTIVE To analyze the risk factors of carotid atherosclerosis in physical examination population at different blood pressure levels. METHODS A total of 6,912 subjects were retrospectively selected from people who underwent a physical examination and carotid artery color ultrasound examination at the medical examination center of The Affiliated Traditional Chinese Medicine Hospital of Southwest Medical University from January 2020 to December 2023. The subjects were divided into carotid atherosclerosis group (n = 2,629) and normal carotid artery group (n = 4,283) according to the results of carotid artery ultrasound. Logistic regression was used to analyze the contributing risk factors of carotid atherosclerosis in people with different blood pressure. RESULTS The detection rate of carotid atherosclerosis in the subjects was 38.04% (2,629/6,912). The detection rates of carotid atherosclerosis in the normal blood pressure group, the high–normal blood pressure group, and the hypertension group were 25.16% (425/1,689), 35.45% (1,076/3,035), and 51.55% (1,128/2,188), respectively. Multivariate logistic regression analysis showed that Males (odds ratio [OR] = 2.091, 95% confidence interval [CI] 1.791–2.442), age (compared with ≤40 years, OR = 3.945, 95% CI 3.166–4.916 for 40–50 years, OR = 9.000, 95% CI 7.265–11.149 for >50–60 years, OR = 17.973, 95% CI 13.964–23.134 for >60–70 years, OR = 41.994, 95% CI 30.243–58.312 for >70 years), hypertension (OR = 1.416, 95% CI 1.210–1.658), increased fasting blood glucose (OR = 1.523, 95% CI 1.279–1.814), increased LDL-C (compared with LDL-C <6.1 mmol/L, OR = 1.278, 95% CI 1.050–1.555 for 6.1–<7.0 mmol/L, OR = 1.523, 95%CI 1.279–1.814 for ≥7.0 mmol/L), white blood cell count (OR = 1.047, 95% CI 1.009–1.086), and platelet count (OR = 1.001, 95% CI 1.000–1.002) were independent risk factors for carotid atherosclerosis (all P < 0.05). In people with normal blood pressure, male, age, fasting blood glucose ≥7.0 mmol/L, increased LDL-C, and mononuclear cell count were independent risk factors for carotid atherosclerosis (all P < 0.05). In people with normal–high blood pressure, male, age, fasting blood glucose levels, and increased LDL-C were independent risk factors for carotid atherosclerosis (all P < 0.05). In hypertensive people, age, fasting blood glucose ≥7.0 mmol/L, increased LDL-C, neutrophils, and creatinine were independent risk factors for carotid atherosclerosis (all P < 0.05). CONCLUSIONS Age, increased fasting blood glucose, and increased LDL-C are common risk factors for carotid atherosclerosis in people with different blood pressures. Besides these factors, male and monocyte count are independent risk factors for carotid atherosclerosis in people with normal blood pressure, male is an independent risk factor for carotid atherosclerosis in people with normal–high blood pressure, and neutrophils and creatinine are independent risk factors for carotid atherosclerosis in people with hypertension.