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Carotid bruits and their clinical significance
Insights
Carotid bruits, or vascular murmurs in the neck arteries, are linked to a higher stroke risk. This finding highlights their importance as a sign of severe atherosclerotic cerebrovascular disease.
Area of Science:
- Cardiovascular Medicine
- Neurology
- Geriatrics
Background:
- Carotid bruits are audible vascular sounds associated with turbulent blood flow.
- Prevalence and clinical significance of carotid bruits in older adults require further investigation.
Purpose of the Study:
- To determine the prevalence of carotid bruits in outpatients aged 40 and older.
- To investigate the association between carotid bruits, carotid calcification, and cerebrovascular disease history.
Main Methods:
- Screening 1,777 outpatients for carotid bruits.
- Assessing carotid artery calcification using cervical spine X-rays in patients 60 years and older.
- Analyzing patient histories for cerebrovascular events.
Main Results:
- Carotid bruits were detected in 4.6% of patients, with prevalence increasing significantly with age.
- Carotid calcification was 3.4 times more common in patients with carotid bruits compared to those without (p < 0.01).
- Patients with carotid bruits had a significantly higher incidence of prior cerebral bleeding or infarction (23.2% vs. 3.8%, p < 0.01).
Conclusions:
- Carotid bruits are a significant indicator of increased stroke risk.
- The presence of carotid bruits suggests severe atherosclerotic cerebrovascular disease.
- Carotid bruits serve as a general, non-focal marker for advanced cerebrovascular atherosclerosis.
Abstract:
Vascular murmurs were routinely sought over the carotid arteries in 1,777 outpatients of 40 years of age or older who attended the cardiovascular clinic of our institute, and carotid bruits were heard in 82 patients (4.6%). The prevalence of carotid bruits increased with age from 5/467 (1.1%) in patients aged 40 to 49 years to 26/150 (17.3%) in those aged 70 to 79 years. Calcification of the carotid arteries was examined by posteroanterior films of the cervical spine in 447 patients 60 years of age or older and carotid calcification was found in 20 (42.6%) of 47 patients with carotid bruits and in 50 (12.5%) of 400 patients without them. The incidence of carotid calcification in the former group was 3.4 times that in the latter (p less than 0.01), although the incidences of hypertension and glucose intolerance were not related to the presence or absence of carotid bruits. A history of cerebral bleeding or infarction was found in 19 (23.2%) of 82 patients with carotid bruits, as compared with 64 (3.8%) of 1,695 patients without them (p less than 0.01). However, the location of the cerebrovascular lesions did not necessarily correlate with the laterality of the carotid bruits. These results indicate that patients with carotid bruits show an increased risk of stroke and that these bruits are a general and non-focal sign of severe atherosclerotic cerebrovascular disease.