The Prevalence of Cardiovascular Risk Factors in People with Initial Presentation of Cerebral Ischemia
Keywords:the initial stages of cerebrovascular insufficiency, endothelial dysfunction, cardiovascular risk factors
Cerebrovascular insufficiency on the early pre-clinical stages of development is the least studied aspects of cerebrovascular pathology.
The purpose of the study is to identify the incidence and establish correlation between the main cardiovascular risk factors and impaired vasomotor endothelial function in patients without clinically significant cardiovascular events (heart attack and stroke) in history.
Material and methods. Under our supervision there were 295 people aged from 30 to 65 years old, mean age was 50.70 ± 7.76 years old (Me = 51, Q1 = 46; Q3 = 57). Among the patients there were 80 (27.1 %) males and 215 (72.9 %) females. All patients were undergone general clinical, neurological and instrumental examination to determine the extent and stage of cerebrovascular pathology. There were identified the main risk factors in patients, namely hypertension (AH), smoking, dyslipidemia, diabetes mellitus (DM) and impaired glucose tolerance, increased body weight. Vasomotor function of endothelium was determined by the concentration of stable metabolite of nitric oxide — nitrite (mmol/l) and endothelin-1 (ng/ml).
The results. Among the patients the most common risk factors for cardiovascular diseases were hypertension (65.8 %) and increased body weight (47.1 %). The study found that there is a relationship between risk factors and clinical severity of cerebrovascular disease (χ2(3) Pearson; Cramer V criterion): AH (112.612, p < 0.001; 0.618, p < 0.001); DM/impaired glucose tolerance (14.683, p = 0.002; 0.223, p = 0.002); increased body weight (32.881, p < 0.0001; 0.343, p < 0.0001). The correlation between diagnosis and smoking (6.855, р = 0.077; 0.152, р = 0.077) or with dyslipidemia (5.904, р = 0.116; 0.202, р = 0.116) was not statistically significant. Risk factors such as DM and increased body weight had an average degree of correlation, and hypertension had a very strong relationship. Among patients with hypertension there were significantly less people with vascular dystonia (5.7 %/53); mainly hypertension occurred in patients with circulatory encephalopathy II (90.3 %/31). A similar situation was observed regarding to the prevalence of overweight (22.6 %/53 and 80.6 % /31, respectively). There was an association between the number of risk factors and the age of a patient (χ2(10) = 29.226, p = 0.001; V Cramer = 0.223, p = 0.001). The disease deterioration was associated with significantly decreased level of nitrite and the increased level of endothelin-1. There was established the correlation (according to Spearman coefficient) between nitrite concentration and the number of risk factors (–0,262, p = 0.002); between endothelin-1 concentration and the number of risk factors (0.288, p = 0.002).
Conclusions. Correlation between risk factors and biochemical markers of endothelial vasomotor function shows the importance of the timely identification and correction of vascular risk factors for the prevention of brain vascular diseases.
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