ECHOGRAPHIC EVALUATION OF CAROTID ATHEROS CLEROSIS BY 2-DIMENSION ULTRASONOGRAPHY IN PATIENTS WITH PRIMARY HYPERCHOLESTEROLEMIA

BACKGROUND: Two-dimension ultrasonography permits to noninvasively qua ntify extracoronary atherosclerosis. The objective of this study was t o assess preclinical atherosclerosis of the extracranial carotid arter ies in patients with primary hypercholesterolemia. METHODS: Lipid and nonlipid cardiovascular risk factors were evaluated in 206 patients wi th dyslipidemia (127 men and 79 women, mean age 49 years, range 18-75) , and a multifactorial cardiovascular risk profile was constructed for each patient. Ultrasound measurements of the intima-media thickness i n the common carotid artery of each side were taken, and the number an d height of any atheroma plaques present were quantified, RESULTS: Asy mptomatic plaques were found in 120 patients (58%), and were more freq uent in men than in women (65 vs 47%, p = 0.009), and in patients with than in those without prior coronary heart disease (80 vs 50%, p < 0. 001). Both intimal thickening, indicative of early atherosclerosis, an d the extent of arterial wall involvement with plaques, which represen ts an advanced stage of the disease, increased significantly with age and with increasing multifactorial cardiovascular risk, reflecting a p ositive relation between signs of atherosclerosis and the burden of ri sk factors. Intima-media thickness also increased with increasing plaq ue score, indicating the generalization of atherosclerosis, CONCLUSION S: The high prevalence of preclinical carotid atherosclerosis confirms the atherogenic risk of primary dyslipidemias. The relation between c arotid lesions and both coronary heart disease and multifactorial risk supports the validity of arterial ultrasound studies for cardiovascul ar risk prediction.