title: Sonographic carotid plaque morphologic characteristics and vascular risk factors: results from a population study.
abstract: OBJECTIVE
  The role of vascular risk factors in atherosclerosis development is well established, whereas risk factors involved in determining plaque vulnerability are still a matter of debate. We investigated the vascular risk factor distribution in patients with carotid plaques.
  
  
  METHODS
  We consecutively assessed sonographic plaque morphologic characteristics, the degree of stenosis, and the common carotid artery intima-media thickness (IMT) in 1655 patients. Demographic data, a documented history of symptomatic cerebrovascular disease (CVD), and the presence of vascular risk factors were collected. According to literature, heterogeneous hypoechoic plaques with an irregular surface or ulcerations and those with a severe degree of stenosis (>or=70%) have been considered "complex" plaques at "major" risk of stroke; homogeneous hyperechoic plaques with smooth surface lesions have been considered "simple" plaques at minor risk.
  
  
  RESULTS
  Univariate analysis showed that all vascular risk factors were associated with the presence of carotid atherosclerotic lesions. Multiple logistic regression showed an independent association of hypertension and diabetes with complex plaques, which also had a thicker IMT. A history of CVD was observed more frequently in complex plaques, which had a higher stenosis percentage even after patients with a severe degree of stenosis (>or=70%) and indications for carotid surgery were excluded.
  
  
  CONCLUSIONS
  Hypertension and diabetes are related to a thicker IMT and more severe complex plaques, which may reflect the instability of atherosclerotic process. Because two-thirds of the patients with complex plaques were asymptomatic for CVD, this raises the importance of surveillance sonography to monitor plaque evolution for prevention of symptomatic CVD.
authors: Department of Neurological Sciences, University of Rome, La Sapienza, Rome, Italy. edoardo.vicenzini@uniroma1.it
authors: Edoardo
authors: E
authors: Vicenzini
authors: Maria Chiara
authors: MC
authors: Ricciardi
authors: Francesco
authors: F
authors: Puccinelli
authors: Marta
authors: M
authors: Altieri
authors: Nicola
authors: N
authors: Vanacore
authors: Vittorio
authors: V
authors: Di Piero
authors: Gian Luigi
authors: GL
authors: Lenzi
mesh_terms: D000368:Aged; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D016893:Carotid Stenosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000453:epidemiology; D018618:Echocardiography, Doppler, Color / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000453:epidemiology; D015994:Incidence; D007558:Italy / Q000453:epidemiology; D008297:Male; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors