title: Prevalence of carotid stenosis in a high-risk Caribbean population.
abstract: OBJECTIVE
  The purpose of this study was to determine the prevalence of carotid stenosis among patients presenting to the University Hospital of West Indies (UHWI) Accident and Emergency Department (A&E) with an ischemic stroke or transient ischemic attack (TIA).
  
  
  METHODS
  Beginning in August 2006, all patients presenting to the UHWI A&E with an acute stroke or TIA were screened for enrollment. Patients were excluded if they had a hemorrhagic stroke or if informed consent could not be obtained. Demographic and clinical information were collected by chart review and interviewer-administered questionnaires. All participants had noncontrast head computed tomography (CT) and bilateral carotid duplex ultrasounds.
  
  
  RESULTS
  133 patients were enrolled in the study. 90% presented with a stroke and 10% with a TIA. Mean age was 64 years, 52% were male, 96% self-identified as black. 78% had diabetes mellitus or hypertension or both, 27% were current or past smokers. 65.1% had a normal carotid ultrasound, 28.5% had <50% stenosis, 1.6% had 50% to 69% stenosis, 0.8% had >or=70% stenosis to near occlusion, 1.6% had near occlusion and 1.6% total occlusion.
  
  
  CONCLUSIONS
  The prevalence of moderate or high-grade carotid stenosis in this high-risk black Caribbean population presenting with an ischemic stroke or a TIA is 5.6%. This is lower than that described in other populations. Further studies are needed to determine the cost-effectiveness of routine screening for carotid stenosis in this population.
authors.affiliation: Departments of Surgery, the Tropical Metabolism Research, The University of the West Indies, Kingston, Jamaica, West Indies. hbrown7@hotmail.com
authors.forename: Hilary A
authors.initials: HA
authors.lastname: Brown
authors.forename: Marilyn B
authors.initials: MB
authors.lastname: Lawrence-Wright
authors.forename: Sundeep
authors.initials: S
authors.lastname: Shah
authors.forename: Sara G
authors.initials: SG
authors.lastname: Lawrence
authors.forename: David
authors.initials: D
authors.lastname: Gilbert
authors.forename: Ivor
authors.initials: I
authors.lastname: Crandon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044383:Black People; D001794:Blood Pressure / Q000502:physiology; D002545:Brain Ischemia / Q000150:complications / Q000453:epidemiology; D016893:Carotid Stenosis / Q000175:diagnosis / Q000191:economics / Q000453:epidemiology*; D003362:Cost-Benefit Analysis; D003920:Diabetes Mellitus / Q000453:epidemiology; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D002546:Ischemic Attack, Transient / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012306:Risk; D012907:Smoking / Q000453:epidemiology; D020521:Stroke / Q000453:epidemiology / Q000209:etiology; D014900:West Indies / Q000453:epidemiology; D055815:Young Adult