[Factors influencing progression and regression of carotid intima-media thickening and plaques in population in 10 areas of China].

Objective: To investigate the influencing factors of progression and regression of carotid intima-media thickening and carotid plaques in a Chinese population, and to provide evidence for the early prevention and intervention of atherosclerosis. Methods: Based on data from 11 416 participants in the second resurvey (August 2013 to September 2014) and the third resurvey (August 2020 to December 2021) of China Kadoorie Biobank Study, combined with questionnaire data, physical measurements, and blood biomarker measurements, multivariable logistic regression models were used to identify factors associated with the progression, persistence, or regression of carotid intima-media thickening and carotid plaque through stratified analyses. Results: It was found that older age was significantly associated with an elevated risk of new carotid intima-media thickening (P<0.001) and new carotid plaque (P<0.001). Being man (OR=1.37, 95%CI: 1.15-1.62), current smoking or smoking cessation due to illness (OR=1.26, 95%CI: 1.04-1.51), higher LDL-C levels (OR=1.31, 95%CI: 1.22-1.40), and hypertension (OR=1.18, 95%CI: 1.05-1.34) were significantly associated with an increased risk of incident carotid intima-media thickening, while higher HDL-C levels were significantly associated with a reduced risk of incident carotid intima-media thickening (OR=0.78, 95%CI: 0.66-0.91). Among participants with existing carotid intima-media thickening, men (OR=0.53, 95%CI: 0.37-0.76), those with higher LDL-C levels (OR=0.74, 95%CI: 0.64-0.87), and hypertension (OR=0.66, 95%CI: 0.50-0.86) were less likely to have the regression of carotid intima-media thickening. Current smoking or smoking cessation due to illness (OR=1.28, 95%CI: 1.05-1.55), daily excessive alcohol consumption (OR=1.35, 95%CI: 1.05-1.72), low body weight (OR=1.72, 95%CI: 1.25-2.37), higher LDL-C levels (OR=1.20, 95%CI: 1.11-1.29), hypertension (OR=1.54, 95%CI: 1.35-1.75), and diabetes (OR=1.39, 95%CI: 1.10-1.75) were associated with an increased risk of new carotid plaque. In individuals with existing carotid plaques, older adults (age ≥60: OR=0.28, 95%CI: 0.18-0.42) and those with elevated LDL-C levels (OR=0.83, 95%CI: 0.72-0.95) were less likely to have carotid plaque regression. Conclusions: Atherosclerosis is modifiable. Effective management of blood lipids, smoking cessation, limiting alcohol intake, and the effective control of blood pressure, blood glucose and body weight are clinically important strategies for the prevention and regression of atherosclerosis, potentially delaying or even reversing disease progression.