Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis.
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.
de Weerd
Marjolein
M
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.
Greving
Jacoba P
JP
Hedblad
Bo
B
Lorenz
Matthias W
MW
Mathiesen
Ellisiv B
EB
O'Leary
Daniel H
DH
Rosvall
Maria
M
Sitzer
Matthias
M
Buskens
Erik
E
Bots
Michiel L
ML
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