RESUMEN
Microvasculopathies of nephrosclerosis progress with age in contrasting patterns. Arterial intimal fibroplasia (R(r) and R(c), respectively, in small and large interlobular arteries) previously showed close linkages to hypertension and to "nephrosclerosis," defined by fibrous replacement of atrophied nephrons, whereas hyalinization of arterioles (Hy) failed to show consistent linkages. In this study, renal samples from seven populations, three newly assembled and four reassessed from archived data, were evaluated for R(r), R(c), and Hy in forensic autopsies of basal subjects (ie, those lacking conditions known to correlate with hypertension or nephrosclerosis, mostly deaths by violence). The patterns of progression on age were alike in all populations, but the rates of progression differed greatly. The observed ranges indicate a 547% higher rate for Hy in the fastest compared with the slowest population, a 49% higher rate for R(c), and a 107% higher rate for R(r). About one third of variation in R(r) and R(c) between populations can be attributed to the correlation with Hy, leaving a substantial residual effect independent of Hy. The findings suggest that the etiology propelling hyalinization in arterioles seems somehow to accelerate the progression of intimal fibroplasia in arteries. The reverse direction, fibroplasia somehow accelerating hyalinization, seems unreasonable, because the presumed consequence, Hy, fails to increase notably with age after 40 years, whereas the presumed causes, R(r) and R(c), rise unremittingly into old age. The etiologies of the population differences are of great consequence to public health but remain unknown.
Asunto(s)
Envejecimiento/patología , Arteriosclerosis/patología , Riñón/irrigación sanguínea , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Población Negra , Bolivia , Femenino , Humanos , Hipertensión/patología , Riñón/patología , Corteza Renal/patología , Modelos Lineales , Masculino , Persona de Mediana Edad , Perú , Túnica Íntima/patología , Estados Unidos , Población BlancaRESUMEN
Full lengths of right coronary artery obtained at autopsy and examined in hematoxylin and eosin stained paraffin sections sometimes reveal the presence of at least one instance of atheroma (YesA specimens). YesA specimens are nearly always those with generalized intimal fibroplasia, measured by excessive intimal thickness per smooth muscle cell. Accumulating evidence suggests that aging governs the progression of fibroplasia, and that this fibroplasia is what aging does to the coronary artery in preparation for atheroma. Hyalinization of renal arterioles was previously found to correlate strongly with the presence of coronary atheroma and with the progression of the fibroplasia of aging in race, sex, age matched comparisons of subjects within a population (forensic autopsies in New Orleans). The data reported here reveal the correlation of arteriolar hyalinization with fibroplasia and atheroma to persist in comparisons across geographically diverse populations. The outcome suggests that aging of coronary intima, in so far as it bears upon preparation for atheroma, may vary in rate between populations. This source of variation could offer clues about environmental factors that may modify rates of aging.