The role of carotid ultrasound in assessing carotid atherosclerosis in individuals at low-to-intermediate cardiovascular risk.
OBJECTIVE
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.
UDETMA, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.
Blai
B
Coll
UDETMA, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.
Angels
A
Betriu
Cardiology Department, Rush University Medical School, Chicago, Illinois, United States.
Steve B
SB
Feinstein
UDETMA, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain.
Jose M
JM
Valdivielso
Servicio de Cardiología, Hospital Clínico Universitario San Carlos, Madrid, Spain.
Jose L
JL
Zamorano
UDETMA, Hospital Universitari Arnau de Vilanova, IRBLleida, Lleida, Spain. Electronic address: edfernandez.lleida.ics@gencat.cat.
Elvira
E
Fernández
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D002318:Cardiovascular Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000517:prevention & control; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000503:physiopathology; D059168:Carotid Intima-Media Thickness; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening / Q000379:methods; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011379:Prognosis; D018570:Risk Assessment; D012380:Role; D012720:Severity of Illness Index; D017678:Sex Distribution; D016019:Survival Analysis; D018608:Ultrasonography, Doppler / Q000379:methods*
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