title: Prevalence, Vascular Distribution, and Multiterritorial Extent of Subclinical Atherosclerosis in a Middle-Aged Cohort: The PESA (Progression of Early Subclinical Atherosclerosis) Study.
abstract: BACKGROUND
  Data are limited on the presence, distribution, and extent of subclinical atherosclerosis in middle-aged populations.
  
  
  RESULTS
  The PESA (Progression of Early Subclinical Atherosclerosis) study prospectively enrolled 4184 asymptomatic participants 40 to 54 years of age (mean age, 45.8 years; 63% male) to evaluate the systemic extent of atherosclerosis in the carotid, abdominal aortic, and iliofemoral territories by 2-/3-dimensional ultrasound and coronary artery calcification by computed tomography. The extent of subclinical atherosclerosis, defined as presence of plaque or coronary artery calcification ≥1, was classified as focal (1 site affected), intermediate (2-3 sites), or generalized (4-6 sites) after exploration of each vascular site (right/left carotids, aorta, right/left iliofemorals, and coronary arteries). Subclinical atherosclerosis was present in 63% of participants (71% of men, 48% of women). Intermediate and generalized atherosclerosis was identified in 41%. Plaques were most common in the iliofemorals (44%), followed by the carotids (31%) and aorta (25%), whereas coronary artery calcification was present in 18%. Among participants with low Framingham Heart Study (FHS) 10-year risk, subclinical disease was detected in 58%, with intermediate or generalized disease in 36%. When longer-term risk was assessed (30-year FHS), 83% of participants at high risk had atherosclerosis, with 66% classified as intermediate or generalized.
  
  
  CONCLUSIONS
  Subclinical atherosclerosis was highly prevalent in this middle-aged cohort, with nearly half of the participants classified as having intermediate or generalized disease. Most participants at high FHS risk had subclinical disease; however, extensive atherosclerosis was also present in a substantial number of low-risk individuals, suggesting added value of imaging for diagnosis and prevention.
  
  
  BACKGROUND
  URL: http://www.clinicaltrials.gov. Unique identifier: NCT01410318.
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Leticia
authors.initials: L
authors.lastname: Fernández-Friera
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: José L
authors.initials: JL
authors.lastname: Peñalvo
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Antonio
authors.initials: A
authors.lastname: Fernández-Ortiz
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Borja
authors.initials: B
authors.lastname: Ibañez
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Beatriz
authors.initials: B
authors.lastname: López-Melgar
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Martín
authors.initials: M
authors.lastname: Laclaustra
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Belén
authors.initials: B
authors.lastname: Oliva
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Agustín
authors.initials: A
authors.lastname: Mocoroa
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: José
authors.initials: J
authors.lastname: Mendiguren
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Vicente
authors.initials: V
authors.lastname: Martínez de Vega
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Laura
authors.initials: L
authors.lastname: García
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Jesús
authors.initials: J
authors.lastname: Molina
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Javier
authors.initials: J
authors.lastname: Sánchez-González
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Gabriela
authors.initials: G
authors.lastname: Guzmán
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Juan C
authors.initials: JC
authors.lastname: Alonso-Farto
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Fernando
authors.initials: F
authors.lastname: Civeira
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Henrik
authors.initials: H
authors.lastname: Sillesen
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Stuart
authors.initials: S
authors.lastname: Pocock
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: José M
authors.initials: JM
authors.lastname: Ordovás
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Ginés
authors.initials: G
authors.lastname: Sanz
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.).
authors.forename: Luis Jesús
authors.initials: LJ
authors.lastname: Jiménez-Borreguero
authors.affiliation: From Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain (L.F.-F., J.L.P., A.F.-O., B.I., B.L.-M., M.L., B.O., L.G., J. Molina, G.G., H.S., S.P., J.M.O., G.S., L.J.J.-B., V.F.); Hospital Universitario Montepríncipe, Madrid, Spain (L.F.-F., B.L.-M.); Universidad Autónoma de Madrid, Spain (M.L.); St. Louis University, St. Louis, MO (M.L.); Hospital Clínico San Carlos, Universidad Complutense, Madrid, Spain (A.F.-O., B.I.); Banco de Santander, Madrid, Spain (A.M., J. Mendiguren); Hospital Universitario Quirón, Madrid, Spain (V.M.d.V.); Philips Healthcare, Madrid, Spain (J.S.-G.); Hospital Universitario La Paz, Madrid, Spain (G.G.); Hospital General Universitario Gregorio Marañón, Madrid, Spain (J.C.A.-F.); Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (E.G.); Lipids Unit and Molecular Research Laboratory, Hospital Universitario Miguel Servet, Instituto Aragonés de Ciencias de Salud, Zaragoza, Spain (F.C.); Rigshospitalet, University of Copenhagen, Denmark (H.S.); London School of Hygiene & Tropical Medicine, UK (S.P.); US Department of Agriculture Human Nutrition Research Center on Aging, Tufts University, Boston, MA (J.M.O.); Hospital Universitario La Princesa, Madrid, Spain (L.J.J.-B.); and Mount Sinai School of Medicine, New York (V.F.). valentin.fuster@mountsinai.org.
authors.forename: Valentín
authors.initials: V
authors.lastname: Fuster
mesh_terms: D000328:Adult; D000367:Age Factors; D055109:Ankle Brachial Index; D001012:Aorta, Abdominal / Q000000981:diagnostic imaging / Q000473:pathology; D001018:Aortic Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D001027:Aortography; D058070:Asymptomatic Diseases; D050197:Atherosclerosis / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000473:pathology; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D002340:Carotid Artery Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D015897:Comorbidity; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D018450:Disease Progression; D005260:Female; D005263:Femoral Artery / Q000000981:diagnostic imaging / Q000473:pathology; D005500:Follow-Up Studies; D006801:Humans; D007083:Iliac Artery / Q000000981:diagnostic imaging / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D014463:Ultrasonography
keywords: atherosclerosis; epidemiology; multidetector computed tomography; population; risk assessment; ultrasonography