Risk factors and subclinical carotid atherosclerosis in rotating scheme conditions in the Arctic

Aim. To determine the most significant risk factors (RF) associated with subclinical carotid atherosclerosis (SKA) in people working rotating scheme (RS) in the Arctic, and the role of high blood pressure (BP) in the formation of the atherosclerotic process.

Material and methods. We included 424 men — employees (RS): group 1 (n=294) BP >140/90 mm Hg, group 2 (n=130) with BP <140/90 mm Hg, consistent in age — 46,9+5,8 years (p=0,435), northern work experience — 12,5+4,6 years old (p=0,597). Office blood pressure was 149,4+13,3/97,1+7,3 mm Hg in group 1 (patients with arterial hypertension) and 123,4+7,5/80,5+5,5 mm Hg in group 2. An ultrasound study of the common carotid arteries (CCA) was conducted with the determination of intima-media thickness (IMT) and atherosclerosis plaque (ASP) in the carotid arteries using the NASCET method. We studied blood lipids andRF (smoking, low physical activity, dyslipidemia, overweight (BMI), psycho-emotional overstrain.

Results. In the RS conditions IMT and ASP prevalence in men significantly depend on the BP level. At the same time, the definition of the main RF in men of 30-59 years only in 23% significantly influenced the IMT of CCA. It is described by the multiple regression formula: IMT= 0,09+0,129•ASP+0,010•Age+0,06•Smoking+0,02•Atherogenic index+0,11•systolic BP+0,005•animal fat intake >30% of daily calorage. The logistic regression data showed a significant dependence of ASP imaging probability in the CCA upon age, BP, BMI and the psychoemotional overstrain. The formula of the logistic regression model is: ASP=-13,746+0,103•Age+0,507•BMI+0,037•diastolic BP+0,021•systolic BP+2,2394MT-0,514•psycho-emotional overstrain.

Conclusion. The role of elevated BP as one of the SKA RF, as well as the relationship between IMT and ASP in CCA, does not exclude the role of other RFs, leading to atherosclerosis of the arterial wall. Non-specific inflammation in different layers of the vascular wall with the formation of SCA and/or vascular ageing may be the unifying etiopathogenetic factor. 

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