Carotid artery atherosclerosis among 65-year-old Swedish men - a population-based screening study

Eur J Vasc Endovasc Surg. 2014 Jul;48(1):5-10. doi: 10.1016/j.ejvs.2014.02.004. Epub 2014 Mar 13.

Abstract

Objective: There are limited contemporary epidemiological data on the prevalence of carotid atherosclerosis in the general population. The aim was to determine the prevalence of and risk factors associated with carotid artery atherosclerosis among 65-year-old men.

Methods: This was a population-based screening study. All 65-year-old men in the County of Uppsala, Sweden, who attended screening for abdominal aortic aneurysm (AAA) 2007-2009, were invited for duplex scanning of the carotid arteries.

Results: Of 4801 men invited, 4657 (97%) accepted. Carotid plaques (>2 × 6 mm) were observed in 1169 (25%) men, 94 (2.0%) had carotid stenoses (50-99%), and 15 (0.3%) had occluded carotid arteries. In a multivariate logistic regression model, smoking (OR 1.7, 95% CI 1.5-1.9), hypertension (1.5, 95% CI 1.3-1.7), diabetes mellitus (1.2, 95% CI 1.0-1.5), and coronary artery disease (1.5, 95% CI 1.3-1.8) were associated with prevalence of carotid atherosclerosis (plaque and/or stenosis). The use of antiplatelet agents and statins in participants with a carotid plaque was 20% and 29%, respectively. The corresponding figures in participants with a stenosis were 42% and 41%.

Conclusions: This study offers contemporary data on the prevalence of carotid atherosclerosis in a population-based cohort of 65-year-old men. Most of those at risk had no other clinical manifestation of atherosclerosis, and therefore had no secondary prevention.

Keywords: Atherosclerotic plaque; Carotid stenosis; Prevalence; Screening.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Age Factors
  • Aged
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology*
  • Carotid Stenosis / diagnostic imaging
  • Carotid Stenosis / epidemiology
  • Comorbidity
  • Coronary Artery Disease / epidemiology
  • Diabetes Mellitus / epidemiology
  • Humans
  • Hypertension / epidemiology
  • Logistic Models
  • Male
  • Mass Screening / methods*
  • Multivariate Analysis
  • Odds Ratio
  • Predictive Value of Tests
  • Prevalence
  • Risk Assessment
  • Risk Factors
  • Severity of Illness Index
  • Sex Factors
  • Smoking / adverse effects
  • Smoking / epidemiology
  • Sweden / epidemiology
  • Ultrasonography, Doppler, Duplex*