title: Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis.
abstract: OBJECTIVE
  In the discussion on the cost-effectiveness of screening, precise estimates of severe asymptomatic carotid stenosis are vital. Accordingly, we assessed the prevalence of moderate and severe asymptomatic carotid stenosis by age and sex using pooled cohort data.
  
  
  METHODS
  We performed an individual participant data meta-analysis (23 706 participants) of 4 population-based studies (Malmö Diet and Cancer Study, Tromsø, Carotid Atherosclerosis Progression Study, and Cardiovascular Health Study). Outcomes of interest were asymptomatic moderate (> or =50%) and severe carotid stenosis (> or =70%).
  
  
  RESULTS
  Prevalence of moderate asymptomatic carotid stenosis ranged from 0.2% (95% CI, 0.0% to 0.4%) in men aged <50 years to 7.5% (5.2% to 10.5%) in men aged > or =80 years. For women, this prevalence increased from 0% (0% to 0.2%) to 5.0% (3.1% to 7.5%). Prevalence of severe asymptomatic carotid stenosis ranged from 0.1% (0.0% to 0.3%) in men aged <50 years to 3.1% (1.7% to 5.3%) in men aged > or =80. For women, this prevalence increased from 0% (0.0% to 0.2%) to 0.9% (0.3% to 2.4%).
  
  
  CONCLUSIONS
  The prevalence of severe asymptomatic carotid stenosis in the general population ranges from 0% to 3.1%, which is useful information in the discussion on the cost-effectiveness of screening.
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Internal mail Str 6.131, PO Box 85500, 3508 GA Utrecht, The Netherlands.
authors.forename: Marjolein
authors.initials: M
authors.lastname: de Weerd
authors.forename: Jacoba P
authors.initials: JP
authors.lastname: Greving
authors.forename: Bo
authors.initials: B
authors.lastname: Hedblad
authors.forename: Matthias W
authors.initials: MW
authors.lastname: Lorenz
authors.forename: Ellisiv B
authors.initials: EB
authors.lastname: Mathiesen
authors.forename: Daniel H
authors.initials: DH
authors.lastname: O'Leary
authors.forename: Maria
authors.initials: M
authors.lastname: Rosvall
authors.forename: Matthias
authors.initials: M
authors.lastname: Sitzer
authors.forename: Erik
authors.initials: E
authors.lastname: Buskens
authors.forename: Michiel L
authors.initials: ML
authors.lastname: Bots
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016893:Carotid Stenosis / Q000191:economics / Q000453:epidemiology*; D005260:Female; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000379:methods; D008875:Middle Aged; D015995:Prevalence; D012720:Severity of Illness Index; D012737:Sex Factors