Epidemiological aspects of carotid disease
- carotid artery,
- carotid artery disease,
- risk factors,
How to Cite
Carotid artery disease most commonly manifests as atherosclerotic carotid artery disease, which can lead to an ischemic stroke. Our aim was to present the epidemiological aspects of carotid disease and to demonstrate the association of risk factors with carotid disease. For that purpose, we prospectively followed 1031 patients at the University Clinic for Cardiology in Skopje, who were examined for carotid stenosis and its correlation with risk factors such as hypertension, smoking, hyperlipidemia, diabetes, obesity and peripheral arterial disease. Results: Carotid stenosis was correlated with arterial hypertension, hyperlipidemia, diabetes mellitus, smoking, and peripheral arterial disease. Conclusions: Our study found that conventional risk factors such as hypertension, diabetes, smoking, and dyslipidemia were independently associated with significant carotid artery disease and peripheral arterial disease.
2. Stary HC. Natural history and histologicalal classification of atherosclerotic lesions: An update. Arterioscler Thromb Vasc Biol 2000;20:1177-1178
3. Virmani R, Kolodgie FD, Burke AP, et al. Atherosclerotic plaque progression and vulnerability to rupture: angiogenesis as a source of intraplaque hemorrhage. Arterioscler Thromb Vasc Biol 2005;25:2054–20
4. The European Stroke Organization (ESO) Executive Committee and the ESO Writing Committee. Guidelines for management of ischemic stroke and transient ischaemic attack 2008, Update January 2009
5. European Stroke Executive Committee and the Eusi Writing Committee. European stroke initiative recommendations for stroke management – Update 2003. Cerebrovasc Dis 2003;16:311-37
6. Feigin VL, Lawes CMM, Bennett DA, Anderson CS. Stroke epidemiology: a review of population based studies of incidence, prevalence and case-fatality in the late 20th century. Lancet Neurol 2003;2:43-53
7. Sacco RL, Wolf PA, Kannel WB McNamara PM. Survival and recurrence following stroke: The Framingham Study. Stroke 1982;13:290-5
8. Vučić-Janković M, Dimitrijevic D, RadovicLj. Kardiovaskularne bolesti u S Jugoslaviji, SZZZ, Beograd, Publikacije zavoda 18, 1996
9. National Center for Health Statistics. Annual summary of births, marriages, divorces and deaths, United States 1994. Monthly Vital Statistics Report 1995; 43:13
10. Prospective Studies Collaboration. Cholesterol, diastolic blood pressure, and stroke.
13.000 strokes in 450.000 people in 45 prospective cohorts. Lancet 1995; 346:1647-53
11. Micieli G, Cavallini A, Bosone D, Poli M, Nappi G. Carotid artery atherosclerosis and risk factors for stroke in a selected population of asymptomatic men. Funct Neuroi 1998; 13(1): 27-35
12. Verhaeghe R. Epidemiology and prognosis of peripheral obliterative arteriopathy. Drugs 1998; 56 (l3): 1-10
13. Strong JP, Guzman MA. Decrease in coronary atherosclerosis in New Orleans Lab Invest 1980; 43: 297
14. Spence JD, Norris et al. Infection, inflammation and atherosclerosis. Stroke 2003; 34: 333-334
15. Tartiere JM, Kesri L, Safar H, Girerd X, Bots M, Safar ME, Blacher J. J Hum Hypertension 2004; 18(5):325-31
16. Arnett DK, Tyroler HA, Burke G, Hutchinson R, Howard G, Heiss G. Hypertension and subc1inical carotid artery atherosc1erosis in blacks and whites. The Atherosc1erosis Risk in Communities Study. ARIC Investigators. Arch Intern Med 1996; 156 (17): 1983-1989
17. Bacha J, Aboud E, Courreges JP. Prevalence and aspects of arteriopathies in noninsulin- dependent diabetes mellitus with severe hypertension. Arch Mal Coeur Vaiss 1997; 90(8): 1065-1069
18. Lewis GF, Rader DJ. New insights into the regulation of hdl metabolism and reverse cholesterol transport. Circ Res 2005;96:1221-1232
19. Irace C, Pujia A, Motti C, Massimo F, Gnasso A. Carotid atherosclerosis in subjects with different hyperlipidaemia phenotypes. Int Angiol 1998; 17(1): 15-21
20. Yasaka M, Yamaguchi T, Shichiri M. Distribution of atherosclerosis and risk factors in atherothrombotic occlusion. Stroke 1993; 24: 206-211
21. Jerrard-Dunne P, Sitzer M, Risley P, Steckel DA, Buehler A, von Kegler S, Markus HS. Interleukin-6 promoter polymorphism modulates the effects of heavy alcohol consumption on early carotid artery atherosclerosis: the Carotid Atherosclerosis Progression Study (CAPS). Stroke 2003; 34: 402-407
22. Paganini - Hill A, Lozano E, Fischberg G, Perez Barreto M, Rajamani K, Ameriso SF et al. Infection and risk of ischemic stroke: differences among stroke subtypes. Stroke 2003; 34(2): 452-7
23. Fox CS, Cupples LA, Chazaro I, Polak JF, Wolf PA, D'Agostino RA at al. Genomewide linkage analysis for internal carotid artery intimal mediai thickness: evidence for linkage rochrornosome 12. Am J Hum Genet 2004; 74: 253-261.
24. Nissen SE, Tsunoda T, Tuzcu EM, Schoenhagen P, Cooper CJ, Yasin M, et al. Effect of recombinant apoa-imilano on coronary atherosclerosis in patients with acute coronary syndromes: A randomized controlled trial. JAMA. 2003;290:2292-2300
25. Furie KL, Kasner SE, Adams RJ, et al. Guidelines for the prevention of stroke in patients with stroke or transient ischemic attack: a guideline for healthcare professionals from the American Heart Association/American Stroke Association. Stroke 2011;42:227–276.
26. Neal B, MacMahon S, Chapman N, Blood Pressure Lowering Treatment Trialists’ Collaboration. Effects of ACE inhibitors, calcium antagonists, and other blood-pressure- lowering drugs: results of prospectively designed overviews of randomised trials. Lancet 2000;356:1955–64
27. Rashid P, Leonardi-Bee J, Bath P. Blood pressure reduction and secondary prevention of stroke and other vascular events: a systematic review. Stroke 2003;34:2741– 8
28. Rothwell PM, Eliasziw M, Gutnikov SA, et al. Endarterectomy for symptomatic carotid stenosis in relation to clinical subgroups and timing of surgery. Lancet 2004;363:915–24
29. Howard G, Manolio TA, Burke GL, et al, The Atherosclerosis Risk in Communities (ARIC) and Cardiovascular Health Study (CHS) Investigators. Does the association of risk factors and atherosclerosis change with age? An analysis of the combined ARIC and CHS cohorts. Stroke 1997; 28(9): 1693–1701
30. Wilson PW, Hoeg JM, D’Agostino RB, et al. Cumulative effects of high cholesterol levels, high blood pressure, and cigarette smoking on carotid stenosis. N Engl J Med 1997;337:516 –22.
31. Psaty BM, Arnold AM, Olson J, et al. Association between levels of blood pressure and measures of subclinical disease multi-ethnic study of atherosclerosis. Am J Hypertens 2006;19:1110 –7
32. Karapanayiotides T, Piechowski-Jozwiak B, van Melle G, et al. Stroke patterns, etiology, and prognosis in patients with diabetes mellitus. Neurology 2004;62:1558–62
33. Haffner SM, Agostino RD Jr, Saad MF, et al. Carotid artery atheroscle-rosis in type-2 diabetic and nondiabetic subjects with and without symptomatic coronary artery disease (The Insulin Resistance Athero- sclerosis Study). Am J Cardiol 2000;85:1395–400
34. Nathan DM, Lachin J, Cleary P, et al. Intensive diabetes therapy and carotid intima- media thickness in type 1 diabetes mellitus. N Engl J Med 2003;348:2294–303
35. Kadoglou NP, Avgerinos ED, Liapis CD. An update on markers of carotid atherosclerosis in patients with Type 2 diabetes. Biomark Med 2010; 4(4):601-9
36. Baigent C, Keech A, Kearney PM, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005;366: 1267–78
37. Briel M, Studer M, Glass TR, et al. Effects of statins on stroke prevention in patients with and without coronary heart disease: a meta- analysis of randomized controlled trials. Am J Med 2004;117:596 – 606
38. Amarenco P, Labreuche J, Lavallee P, et al. Statins in stroke prevention and carotidatherosclerosis: systematic review and up-to-date meta-analysis. Stroke 2004;35:2902–9.
39. Josephson SA, Bryant SO, Mak HK, et al. Evaluation of carotid stenosis using CT angiography in the initial evaluation of stroke and TIA. Neurology 2004;63:457–60
40. O'Regan C, Wu P, ArovrP, Perri 0, Mills EJ. Statin therapy in stroke prevention: a meta- analysis involving 121,000 patients. AmJ Med 2008;121:24-33
41. Živković M, Šternić N, Kostić VS. Ishemična bolest mozga. Zavod za udžbenike I nastavna sredstva, Beograd, 2000
42. Lee P.H., Bang I, S Joo, et al. Pathogenesis of deep white matter medullary infarcts: a diffusion weighted magnetic resonance imaging study. J Neurol Neurosurg Psychiatry 2005;76:1659–1663
43. Howard G, Wagenknecht LE, Cai J, et al. Cigarette smoking and other risk factors for silent cerebral infarction in the general population. Stroke 1998;29:913–7
44. Suk SH, Sacco RL, Boden-Albala B at al. Abdominal obesity and risk of ishemic stroke: the northern Manhatten Stroke Study. Stroke 2003;34: 1586- 1592
45. Casas JP. Hingorani AD, et al. Meta-analysis of genetic studies in ischemic stroke: thirty-two genes involving approximately 18,000 cases and 58,000 controls. Arch Neurol 2004;61:1652-1661
46. Roger VL et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics – 2011 update: a report from the American Heart Association. Circulation 2011;123:e18-e 209
47. Heart Protection Study Collaborative Group. MRC/ BHF Heart Protection Study of cholesterol-lowering with simvastatin in 20.536 high-risk individuals: a randomised placebo-controlled trial. Lancet 2002;360:7-22
48. George J, Rapsomaniki E, Pujades‐Rodriguez M, Shah AD, Denaxas S, Herrett E, Smeeth L, Timmis A, Hemingway H. How does cardiovascular disease first present in women and men? Circulation 2015; 132:1320–1328.
49. Goessens BM, Visseren FL, Kappelle LJ, Algra A, van der Graaf Y. Asymptomatic carotid artery stenosis and the risk of new vascular events in patients with manifest arterial disease: the SMART study. Stroke 2007; 38:1470–1475.
50. de Weerd M, Greving JP, Hedblad B, Lorenz MW, Mathiesen EB, O'Leary DH, et al. Prevalence of asymptomatic carotid artery stenosis in the general population: an individual participant data meta-analysis. Stroke 2010; 41:1294–1297