Age-dependence of risk factors for carotid stenosis: an observational study among candidates for coronary arteriography

In order to identify subjects at higher risk for carotid stenosis and to pr ovide insights into mechanisms of disease development at different age-inte rvals, a color duplex ultrasound of extracranial arteries was performed in 624 consecutive patients (mean age 62.9 +/- 10.7, 483 males) undergoing cor onary angiography. Significant carotid atherosclerosis 50% stenosis) was do cumented in 87 patients (14%): the disease was moderate (50 - 69% stenosis) in 51 patients (8%), severe (greater than or equal to 70% stenosis) in 36 patients (6%). Age (P < 0.0001), smoking (P < 0.0001), diabetes (P = 0.0002 ), renal dysfunction (P = 0.0119) and hypertension (P = 0.0202) were indepe ndent predictors of significant carotid atherosclerosis; age (P = 0.0001), smoking (P = 0.0009) and diabetes (P = 0.0201) were independent predictors of severe disease. Among 262 candidates for cardiac surgery, significant ca rotid artery disease was identified in 57 cases (2.63 Relative Risk, 95% Co nfidence Intervals: 1.32-5.24). Correlation and regression tree analysis de monstrated that diabetes was associated with greater severity of carotid st enosis in younger patients and hypertension in older ones. In conclusion ag e is the primary determinant of carotid artery disease; diabetes and smokin g accelerate progression of atherosclerosis in younger patients, hypertensi on and smoking in older ones. Among patients undergoing coronary angiograph y, carotid ultrasonography should be recommended in high risk subgroups of patients. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.