Cross-sectionally assessed carotid intima-media thickness relates to long-term risk of stroke, coronary heart disease and death as estimated by available risk functions

Objective. To relate cross-sectionally assessed indicators of carotid ather osclerosis measured in participants of the Rotterdam Study to absolute 10-1 2 year risks of stroke, coronary heart disease and death estimated by risk functions available from other studies. Setting. General population living in the suburb of Ommoord in Rotterdam, T he Netherlands. Subjects. A sample of men and women (n = 1683), aged 55 years or over, draw n from participants from the Rotterdam Study (n = 7983). Main outcomes measures, Three risk scores were used to estimate for each in dividual the absolute risk of stroke, coronary heart disease and death with in 10-12 years as a function of their cardiovascular risk factor profile. C ross-sectionally measured indicators of carotid atherosclerosis (presence o f atherosclerotic lesions and common carotid intima-media thickness) were s ubsequently related to these risk scopes. Results, The 10-year absolute risk of stroke increased linearly from 4.8% ( 95%CI = 3.8, 5.8) for subjects in the lowest quintile to 16.1% (12.3, 21.9) for subjects in the highest quintile of common carotid intima-media thickn ess distribution. Similarly, the 10-year absolute risk for coronary heart d isease rose from 13.1% (95%CI = 12.0, 14.2) to 23.4% (95%CI = 21.4, 25.4), whereas the risk of death within 11.5 years rose from 15.0% (95%CI = 12.8, 17.4) in the lowest quintile to 46.0% (42.8, 49.3) in the upper quintile. T he absolute risks of stroke, coronary heart disease or death rose from 8.8, 15.8 and 26.9% to 14.3, 19.8 and 40.9%, respectively, when plaques in the common carotid artery were present. Similar findings were observed for plaq ues in the carotid bifurcation, Conclusion. Common carotid intima-media thickness and carotid plaques are m arkers for increased risk of stroke, coronary heart disease and death withi n 10-12 years.