Carotid plaques, aging, and risk factors for atherosclerosis

The prevalence of extracranial carotid artery atherosclerosis and its relations to principal cardiovascular risk factors at different ages was evaluated in a sample of general population. High resolution B-mode ultrasonography was used to investigate the carotid district in 457 subjects (231 males and 226 females, mean age 55.4+18.7 years, range 18-97 years) of the metropolitan area. The ultrasonographic findings were then related to primary risk factors. Carotid plaques were found in 178 subjects (38.5%). Prevalence of atherosclerosis, number of plaques and percentage of stenosis have been observed to increase with age. The main cardiovascular risk factors resulted significantly associated with carotid atherosclerosis in the total series and, more strongly, in subjects under 65 years. In the group aged 65 years and over, most of these associations were no longer found. In the multiple logistic regression model, analysis of subjects under 65 years showed positive and independent associations between carotid atherosclerosis and age (p<0.0001), cigarette smoking (p< 0.001), number of cigarettes smoked each day (p<0.01), and a negative association with HDL/total cholesterol ratio (p<0.001). The analysis of subjects aged 65 years or more showed positive independent associations only with age (p<0.001) and male gender (p<0.01). In conclusion, there is a high prevalence of asymptomatic carotid atherosclerosis in the general population, particularly in advanced age. In the elderly the association between risk factors and carotid atherosclerosis has not yet been found.