Prevalence of asymptomatic carotid disease: Results of duplex scanning in 348 unselected volunteers

Abstract

The risk of stroke in patients with asymptomatic carotid disease appears to be related to the presence of a high-grade stenosis. To determine the prevalence of such lesions, duplex scanning was performed on 348 unselected volunteers without symptoms who attended hospital-sponsored health fairs. There were 209 women and 139 men whose ages ranged from 24 to 91 years. Risk factors included hypertension (37%), diabetes (8%), and smoking (23%). One hundred seven subjects (31%) had evidence of extracranial carotid artery disease, 13 (4%) with greater than 50% stenosis, and three (1%) with greater than 80% stenosis of the internal carotid artery. Bilateral disease was present in 50 patients. Disease prevalence and severity were significantly correlated with age (p less than 0.001) and hypertension (p less than 0.01) but not with diabetes or smoking. The incidence of disease was similar in men and women. Although carotid plaques are common in people older than 50 years of age who do not have symptoms, the prevalence of high-grade stenosis--even in the elderly hypertension population--is low, casting doubt on the cost-effectiveness of generalized screening.

Frequency and Clinical Correlates of Occlusive Lesions of Cerebral Arteries in Japanese Patients without Stroke

“…Handa et al [6]noted that the frequency of more than 25% narrowing was 26% in 132 Japanese patients carrying risk factors for atherosclerosis but without cerebrovascular disease. Nevertheless, the frequency of carotid artery stenosis more then 50% found in this study (4.5%) was similar to those demonstrated in previous ultrasonography studies ranging from 3 to 5% [4, 5, 6]. No comparative data were available on the intracranial artery diseases in subjects without stroke.…”

“…In addition, detection of mild stenotic lesions would be severely affected by sensitivity and specificity of the technique used. The frequency of cervical carotid arterial stenotic lesions of 11.5% obtained in this study was lower than in previous studies [4, 5, 6]where high-resolution carotid ultrasonography was used. Colgan et al [4]reported that 107 (31%) of 348 unselected volunteers had evidence of extracranial carotid disease.…”

“…The frequency of cervical carotid arterial stenotic lesions of 11.5% obtained in this study was lower than in previous studies [4, 5, 6]where high-resolution carotid ultrasonography was used. Colgan et al [4]reported that 107 (31%) of 348 unselected volunteers had evidence of extracranial carotid disease. Fabris et al [5]found a greater than 25% stenosis in 20.6% of 457 subjects of the general population.…”

“…Previous studies have demonstrated that, in patients with ischemic stroke or transient ischemic attack, risk factors relevant to cervical carotid artery lesions differ from those to intracranial artery lesions [1, 2, 3]. However, although studies using ultrasonography [4, 5, 6, 7]have determined the prevalence of asymptomatic extracranial carotid atherosclerosis and identified relevant risk factors to it, no study has been carried out for intracranial arteries.…”

Asymptomatic Cerebrovascular Disease and Systemic Diagnosis in Stroke, Atherothrombosis as a Disease of the Vascular Tree

“…Several population studies have established that asymptomatic carotid stenosis is 0.5% in individuals >50 years of age, 4.5% between 50 and 79 years, and 10% in individuals >80 years of age [38,39,40,41,42]. Prevalence increases with age, and is 9% in women and 7% in men [43].…”