Segment-specific prevalence of carotid artery plaque and stenosis in middle-aged adults and elders in Taiwan: A community-based study
Chao-Liang Chou1, Yih-Jer Wu2, Chung-Lieh Hung3
1Department of Medicine, Mackay Medical College, New Taipei City, Taiwan; Department of Neurology, Mackay Memorial Hospital, New Taipei City, Taiwan.
Insights
Carotid plaque is more common in the left carotid artery (CA) and at the bifurcation. Advanced carotid atherosclerosis indicates high cardiovascular disease (CVD) risk, necessitating risk factor management.
Area of Science:
- Cardiovascular Medicine
- Vascular Biology
- Public Health
Background:
- Carotid artery (CA) plaque is a key indicator of systemic atherosclerosis and cardiovascular disease (CVD).
- Anatomical differences between left and right CAs may affect CVD predictability.
- Limited data exists on site-specific carotid plaque (CP) prevalence and atherosclerosis severity concerning CVD risks.
Purpose of the Study:
- To investigate the prevalence and distribution of extracranial carotid plaque (CP).
- To analyze the association between carotid atherosclerosis severity and cardiovascular disease (CVD) risk factors.
- To provide insights for CVD prevention and treatment strategies.
Main Methods:
- 1539 healthy residents aged 40-74 years from Taiwan underwent carotid ultrasound and CVD risk factor assessment.
- High-resolution B-mode ultrasound was used to scan carotid arteries.
- Cardiovascular disease risk factors were evaluated for all participants.
Main Results:
- Extracranial CP prevalence was 21.9% in females and 33.8% in males, with the carotid bifurcation being the most affected segment.
- Left CAs showed a higher likelihood of plaque formation (OR=1.32) compared to right CAs.
- Subjects with moderate to severe carotid atherosclerosis had a high estimated 10-year CVD risk (19.1 ± 14.6%), with over 65% requiring intensive management of blood pressure, lipids, or sugar.
Conclusions:
- The carotid bifurcation is the most common site for plaque, and left CAs are more prone to plaque development than right CAs.
- High prevalence of major CVD risk factors and elevated CVD risks were observed in individuals with advanced carotid atherosclerosis.
- Findings support targeted CVD prevention and treatment, particularly for individuals with significant carotid atherosclerosis.
Background:
Plaque in carotid arteries (CAs) is a major factor of systemic atherosclerosis and cardiovascular disease (CVD). The left and right CAs have different anatomic and geometric features and may influence the predictability of CVD. However, the site- and segment-specific prevalence of carotid plaques (CP) and study on severity of carotid atherosclerosis with CVD risks was very limited.
Methods:
We enrolled 1539 healthy residents aged 40-to-74 years from two northern districts in Taiwan. All volunteers received high resolution B-mode carotid ultrasound scans and CVD risk factors evaluations.
Results:
The prevalence rate of extracranial CP was 21.9% in females and 33.8% in males. Carotid bifurcation is the most affected segment. As compared with the right CAs, the age-sex-adjusted matched odds ratio of having plaques in the left CAs was 1.32 (95% confidence interval = 1.02-1.73). The proportions of subjects had a total plaque number≥2, maximum stenosis≥30%, and plaque score≥3 were 8.9, 10.3, and 7.2%, respectively, in females and were 17.7, 17.2, and 15.1%, respectively, in males. Among subjects with moderate and severe carotid atherosclerosis, the mean ± SD of estimated 10-year CVD risk was 19.1 ± 14.6% and more than 65% of them need intensive blood pressure, lipids, or sugar controls.
Conclusion:
We found that bifurcation was the most prevalent segment, and left CAs was more likely to form plaque than right CAs. The major CVD risk factors were highly prevalent and the estimated CVD risks were high in subjects with more advanced carotid atherosclerosis. The study provides further direction for CVD prevention and treatment.
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