The role of carotid ultrasound in assessing carotid atherosclerosis in individuals at low-to-intermediate cardiovascular risk

Rev Esp Cardiol (Engl Ed). 2013 Dec;66(12):929-34. doi: 10.1016/j.rec.2013.05.030. Epub 2013 Oct 26.

Abstract

Introduction and objectives: Detection of carotid atherosclerosis might help to better identify individuals susceptible to cardiovascular events. We aimed to quantify the number of participants with carotid atherosclerosis and low-to-intermediate cardiovascular risk according to the traditional risk factor scoring, and therefore with an elevated risk of cardiovascular events.

Methods: Cross-sectional, observational study performed during a cardiovascular screening program. From a total of 3778 volunteers, low-to-intermediate cardiovascular risk individuals (N=2354) were identified and studied. Physical examination, blood test, and carotid ultrasound followed standard procedures. Common, bulb, and internal carotid arteries were examined and common carotid intima-media thickness was measured. SCORE risk value was calculated for all participants. Univariate and multivariate statistical analysis was performed.

Results: Mean age of participants was 58.9 (15) years, 43.8% were men, 23.7% had hypertension, and 20.5% had hypercholesterolemia. The mean SCORE value was 1.47 (1.4). Both carotid intima-media thickness and the prevalence of carotid plaques increased steadily and significantly (P<.005) as advanced decades of life were analyzed. Variables significantly related with the presence of carotid atherosclerosis were age, male sex, and systolic blood pressure. Interestingly, 592 (25.1%) individuals were reclassified to a higher risk due to the presence of carotid atherosclerosis.

Conclusions: There was a clear dissociation between cardiovascular risk scoring and the presence of atherosclerosis, because 1 of 4 study participants at low-to-intermediate cardiovascular risk had carotid atherosclerosis.

Keywords: Aterosclerosis carotídea; CVD; Cardiovascular prevention; Cardiovascular risk; Carotid atherosclerosis; Carotid intima-media thickness; Grosor íntima-media carotídeo; Prevención cardiovascular; Riesgo cardiovascular; c-IMT; cardiovascular diseases; carotid intima-media thickness.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Adult
  • Age Distribution
  • Aged
  • Analysis of Variance
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / epidemiology*
  • Cardiovascular Diseases / prevention & control
  • Carotid Artery Diseases / diagnostic imaging*
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / physiopathology
  • Carotid Intima-Media Thickness
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Humans
  • Logistic Models
  • Male
  • Mass Screening / methods
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Risk Assessment
  • Role
  • Severity of Illness Index
  • Sex Distribution
  • Survival Analysis
  • Ultrasonography, Doppler / methods*