Stroke, Vol 25, 2377-2383, Copyright © 1994 by American Heart Association
R Li, BB Duncan, PA Metcalf, JR Crouse 3rd, AR Sharrett, HA Tyroler, R Barnes and G Heiss
BACKGROUND AND PURPOSE: There is little information on the distribution of
atherosclerotic lesions of the extracranial carotid artery wall in
free-living populations. The purpose of the present study was to describe
the prevalence from 1987 through 1989 of extracranial carotid artery plaque
and plaque with acoustic attenuation (shadowing) lesions in a general
population of white and black adults from four US communities. METHODS:
B-mode ultrasound was used to characterize wall lesions in the common and
internal carotid arteries and at the carotid artery bifurcation in 14,046
men and women 45 to 64 years old who participated in the Atherosclerosis
Risk in Communities Study baseline survey. RESULTS: Thirty-four percent of
participants had plaque and 6.4% had plaque with acoustic shadowing. The
prevalence of plaque with acoustic shadowing increased steadily with age
from 2.5% at ages 45 to 49 to 12.4% at ages 60 to 64. Overall, whites had
more plaque with acoustic shadowing lesions than blacks (odds ratio [OR],
1.22; 95% confidence interval [CI], 1.02 to 1.46), and men had more than
women (OR, 1.42; 95% CI, 1.22 to 1.63). However, plaque lesions in the
common carotid artery were less common among whites than among blacks, and
no racial difference was observed in the prevalence of plaque with acoustic
shadowing at this segment. CONCLUSIONS: Although these prevalence rates are
likely to be underestimated because of the emphasis on arterial boundary
visualization of the scanning protocol, they show a large, mostly
asymptomatic burden of atherosclerosis in these populations, especially
among older individuals. Site-specific frequency rates of plaque varied
between blacks and whites. Among those with plaque, however, whites had
more lesions with acoustic shadowing attenuation.
ARTICLES
B-mode-detected carotid artery plaque in a general population. Atherosclerosis Risk in Communities (ARIC) Study Investigators
Department of Epidemiology, School of Public Health, University of North Carolina, Chapel Hill 27599.
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