Stroke, Vol 23, 1705-1711, Copyright © 1992 by American Heart Association
P Prati, D Vanuzzo, M Casaroli, A Di Chiara, F De Biasi, GA Feruglio and PJ Touboul
BACKGROUND AND PURPOSE: The aim of this study was to assess the prevalence
of asymptomatic carotid atherosclerotic lesions and their relation to
principal risk factors. The importance of the relation between asymptomatic
carotid atherosclerotic lesions, stroke, and coronary atherosclerosis has
been widely discussed, but there are few transversal and longitudinal
studies on a general population. METHODS: A noninvasive examination was
carried out using high-resolution B-mode ultrasonography, which has been
shown to be a reliable tool for epidemiological studies. We examined 630
men and 718 women aged 18-99 years (participation rate, 74.9%). RESULTS:
The global prevalence of carotid atherosclerosis was 25.4% in men and 26.4%
in women. Intimal- medial thickening was found in 9.4% of men and 11.7% of
women. Plaque prevalence was 13.3% in men and 13.4% in women; prevalence of
stenotic plaques was 2.7% and 1.5%, respectively. Subjects aged < or =
39 years showed a very low prevalence of any asymptomatic carotid
atherosclerotic lesions. In the multiple logistic regression, the analysis
of subjects aged > or = 40 years showed a positive significant
association between the severity of carotid atherosclerotic lesions
(plaques and stenosis) and age (p < 0.001), systolic blood pressure (p
< 0.01), cigarette smoking (p < 0.0001), and the protective effect of
high density lipoprotein cholesterol (p < 0.037). This analysis did not
provide evidence of a clear-cut association between risk factors and
intimal-medial thickening. CONCLUSIONS: This population study shows the
high prevalence of asymptomatic carotid atherosclerotic lesions in a
general population (approximately 25% of adults) and its relation with the
classic risk factors. It emphasizes the value of ultrasonography in the
detection of early atherosclerotic lesions.
ARTICLES
Prevalence and determinants of carotid atherosclerosis in a general population
Neurology Department, San Daniele Hospital, San Daniele UD, Italy.
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