2000 Volume 37 Issue 10 Pages 811-818
This study was conducted to evaluate the relationship between arteriosclerosis and lipoprotein (a) [Lp(a)] from the point of view of aging. A total of 354 patients (167 men) aged 60 or more were enrolled and serum Lp (a) levels, vascular risks, and complications were studied. Patients were divided into 3 groups according to age: group I (n=73: aged 60 to 69), group II (n=144: aged 70-79), and group III (n=137: aged 80 or more). Vascular complications were assessed by carotid ultrasonography (US), ECG, and ankle pressure index (API). US findings were stratified according to the distribution of plaque lesions in unilateral and bilateral lesions, while plaque types were subdivided based on the morphology and US echogenicity. Male patients with risk factors (diabetes, hypercholesterolemia, cigarette smoking) as well as stroke were frequent in group I, indicating some selection bias. However, there was no difference in Lp (a) level among the three groups. Carotid lesions, especially bilateral lesions with more thickened plaques, and low API were both significantly frequent in group III. Logistic regression analysis showed that carotid lesions were influenced not only by aging, but also independently by high Lp (a) levels in group III, and by hypertension in group II. A high Lp (a) level was related to hypercholesterolemia and hypoechoic plaque. These findings indicated that atherosclerosis, which developed in both the carotid and peripheral arteries with aging, was related to different risks in each decade of life. Furthermore, it seems that a long period of high Lp (a) levels may promote the formation of hypoechoic plaque.
