Original articleThe Role of Carotid Ultrasound in Assessing Carotid Atherosclerosis in Individuals at Low-to-intermediate Cardiovascular RiskPapel de la ecografía carotídea en la reclasificación del riesgo cardiovascular de sujetos de riesgo bajo–intermedio
Section snippets
INTRODUCTION
Primary prevention of cardiovascular diseases (CVD) is based on the identification of high-risk individuals. However, the traditional cardiovascular risk factor approach is not efficient and not adequately inclusive. Interestingly, just 1 out of 4 young participants with coronary heart disease met the National Cholesterol Education Program criteria for treatment with statins, leading researchers to conclude that the risk factor approach underappreciates risk, especially in young people.1
Design and Procedures
This is a cross-sectional, observational study performed in 7 cities in Spain (Alicante, Ourense, Barcelona, Madrid, Valladolid, Zaragoza, and Sevilla) during a 1-year information campaign run by the Spanish Heart Foundation and both the Spanish and European Societies of Cardiology. The study was organized similarly in each city during a whole weekend (Saturday and Sunday). A specific place (consisting of several large tents) was established in a centric or highly crowded place and
General Characteristics and Atherosclerosis Assessment
We screened 3778 individuals during the study, excluding 938 because of diagnoses of type 2 diabetes mellitus, previous coronary heart disease or stroke, or a SCORE cardiovascular risk value >5%. Of the remaining pool (2840) of participants, 2354 individuals had the full examination. General characteristics of the population included in the study, by decades of life, are listed in Table 1.
Mean age was 58.9 (15) years and 43.8% were males. The distribution between males/females was not
DISCUSSION
CVD are the leading cause of death in industrialized countries and many of them are atherosclerosis-related events. The aim of the current study was to quantify the burden of atherosclerosis (measured by c-IMT and the presence of carotid plaques) noninvasively in a group of apparently healthy individuals with low-to-intermediate cardiovascular risk according to SCORE. The main result is that 25.1% of individuals have carotid plaques. We have to highlight that these participants were not
CONCLUSIONS
As CVD remain the number one killer in the developed world, additional efforts to better define preclinical disease need to be developed and adopted. Carotid ultrasound assessment of preclinical atherosclerosis is valued for the assessment of atherosclerosis and in predicting CVD, and according to our data 25.1% of apparently healthy participants at low-to-intermediate cardiovascular risk according to SCORE presented with carotid plaques. These results are encouraging. Now it may be time to
CONFLICTS OF INTEREST
None declared.
Acknowledgements
We are especially thankful to UDETMA components for their involvement in the current research project. GE Healthcare Spain was actively involved in the logistics and in providing the ultrasound portable devices (Sonia Mora, Mario Lois and Juan Antonio Beceiro). We also thank the Spanish Society of Cardiology and the Spanish Heart Foundation for the organization of the screening program.
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