Background:Absence of cardiovascular risk factors (RF) in young adulthood is associated with a lower risk for cardiovascular disease. However, it is unclear if low RF burden in young adulthood decreases the quantitative burden and qualitative features of atherosclerosis.Methods:Multi-contrast carotid magnetic resonance imaging was performed on 440 Chicago Healthy Aging Study participants in 2009 to 2011, whose RF (total cholesterol, blood pressure, diabetes mellitus, and smoking) were measured in 1967 to 1973. Participants were divided into 4 groups: low-risk (with total cholesterol <200 mg/dL and no treatment, blood pressure <120/80 mm Hg and no treatment, no smoking, and no diabetes mellitus), 0 high RF but some RF unfavorable (≥1 RF above low-risk threshold but below high-risk threshold), 1 high RF (total cholesterol ≥240 mg/dL or treated, blood pressure ≥140/90 or treated, diabetes mellitus, or smoking), and 2 or more high RF. Association of baseline RF status with carotid atherosclerosis (overall mean carotid wall thickness and lipid-rich necrotic core) at follow-up was assessed.Results:Among 424 participants with evaluable carotid magnetic resonance images, the mean age was 32 years at baseline and 73 years at follow-up; 67% were male, 86% white, and 36% were low-risk at baseline. Two or more high RF status was associated with higher carotid wall thickness (0.99±0.11 mm) and lipid-rich necrotic core prevalence (30%), as compared with low-risk group (0.94±0.09 mm and 17%, respectively). Each increment in baseline RF status was associated with higher carotid wall thickness (β-coefficient, 0.015; 95% CI, 0.004–0.026) and with higher lipid-rich necrotic core prevalence at older age (odds ratio, 1.26; 95% CI, 1.00–1.58) in models adjusted for baseline RF and demographics.Conclusions:RF status in young adulthood is associated with the burden and quality of carotid atherosclerosis in older age suggesting that the decades-long protective effect of low-risk status might be mediated through a lower burden of quantitative and qualitative features of atherosclerotic plaque.

中文翻译：

---

长期危险因素水平与颈动脉粥样硬化的关联：芝加哥健康衰老磁共振成像斑块研究（CHAMPS）。

背景：成年后没有心血管危险因素（RF）与心血管疾病的风险较低相关。然而，目前尚不清楚低RF负荷是否能降低年轻人的定量负担和定性特征。方法：2009年至2011年对440名芝加哥健康老龄化研究参与者进行了多对比颈动脉核磁共振成像，他们的RF（总胆固醇） ，血压，糖尿病和吸烟）的测量范围为1967年至1973年。参与者分为四组：低危（总胆固醇<200 mg / dL，不接受治疗，血压<120/80 mm Hg，不接受）治疗，不吸烟，无糖尿病），0高RF但有些RF不利（≥1 RF高于低风险阈值但低于高风险阈值），1高RF（总胆固醇≥240mg / dL或已治疗）血压≥140/ 90或已治疗，糖尿病或吸烟），且RF≥2。在随访中评估了基线RF状态与颈动脉粥样硬化（总平均颈动脉壁厚和脂质丰富的坏死核心）的关系。结果：在424名具有可评估颈动脉磁共振图像的参与者中，平均年龄在基线时为32岁，在73岁时平均年龄为73岁。随访年数；基线时男性占67％，白人占86％，低风险占36％。与低风险组（分别为0.94±0.09 mm和17％）相比，两个或多个高RF状态与较高的颈动脉壁厚度（0.99±0.11 mm）和富含脂质的坏死核心患病率（30％）相关。基线射频状态的每一次增加都与颈动脉壁厚增加有关（β系数，0.015； 95％CI，0.004-0。