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Prevalence and cardiovascular risk factors of asymptomatic intracranial arterial stenosis: The Kongcun Town Study in Shandong, China.

BACKGROUND: To investigate the prevalence and cardiovascular risk factors (CRFs) of asymptomatic intracranial atherosclerotic stenosis (aICAS) among middle-aged and older adults living in rural communities in China.

METHODS: This population-based study included 2019 subjects (age ≥40 years, 52.3% women) who were free of stroke and living in rural communities in China. In October 2017-May 2018, data on demographics, CRFs, and health conditions were collected through face-to-face interviews, physical examination, and laboratory test. We detected aICAS through a two-phase procedure: a screening phase with Transcranial Doppler ultrasound, followed by a diagnostic phase with magnetic resonance angiography examination. We used multivariable logistic regression models to analyze CRFs associated with aICAS.

RESULTS: Of the 2019 participants, aICAS was detected in 153 persons. The overall prevalence of aICAS was 7.6%, and the prevalence of moderate-to-severe aICAS was 5.0%. The multi-adjusted odds ratio (95% confidence interval) of aICAS associated with CRFs was 2.40 (1.56-3.69) for hypertension, 1.91 (1.32-2.76) for high hypersensitive C-reactive protein, 1.68 (1.14-2.49) for diabetes, and 1.61 (1.08-2.41) for overweight or obesity. When these four CRFs were aggregated, compared with participants without any of these four factors, the multi-adjusted odds ratios (95% CI) of aICAS for persons concurrently having 1, 2, and ≥3 of these factors were 1.14 (0.52-2.48), 2.91 (1.42-5.99), and 5.51 (2.64-11.50), respectively (P for linear trend <0.001).

CONCLUSIONS: Asymptomatic ICAS is common among rural-dwelling middle-aged and older Chinese people. Hypertension, diabetes, overweight or obesity, and high hypersensitive C-reactive protein, especially when coexisting, are strongly associated with aICAS.

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