Key result
Hypertension links to increased carotid IMT, while ~35% of routine ultrasounds are performed inappropriately.
Why the study?
The appropriateness and findings of carotid artery studies including IMT measurement and plaque assessment in routine clinical practice were not well described.
Cross-Sectional (n=555)
No
Mean Difference: 0.0391 (95% CI 0.019–0.0592)
p-value: p=0.001
A significant proportion (35%) of routine carotid artery assessments for IMT and plaque are performed for uncertain or inappropriate reasons, despite findings correlating well with known cardiovascular risk factors.
Questions appropriateness of many carotid ultrasound referrals; confirms IMT links to hypertension and male sex but leaves optimal indications open.
OBJECTIVES: To describe the findings and evaluate appropriateness of a carotid artery study including the measurement of IMT, the presence of atherosclerotic plaque, and their correlation with cardiovascular risk factors. METHODS: 555 patients (220 men; 67.06 +/- 12.44 years) were included in the study. 120 patients (21.62%) presented carotid plaque: 108 (19.45%) in patients with at least one risk factor and 12 (2.1%) in patients without risk factors. With respect to appropriateness of the present studies: 65% were appropriate, 22% were uncertain and 13% were inappropriate. The IMT medians were higher in males (0.0280; 95% CI, 00.82 to 0.478; p = 0.0057) and in hypertensive patients (0.391; 95% CI, 0.0190 to 0.0592; p = 0,001). There was a linear increase in mean IMT for each year increased in age (0.0059; 95% CI; 0.0050 to 0.0067). Carotid plaque was more frequent in patients with CAD (p = 0.0002), diabetes (p = 0.024) and hypertension (p = 0.036). CONCLUSION: Assessment of carotid arteries identified increased incidence of plaque in patients with CAD, diabetes and hypertension. IMT was increased in older patients, hypertensive patients and males. Forty-five percent of the patients were studied based on uncertain and inappropriate reasons.
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Baroncini et al. (2008) conducted a cross-sectional in Patients undergoing routine carotid ultrasound (n=555). Cardiovascular risk factors (hypertension) vs. Patients without hypertension was evaluated on Intima-media thickness (IMT) (MD 0.0391, 95% CI 0.0190-0.0592, p=0.001). Carotid intima-media thickness was significantly increased in hypertensive patients (MD 0.0391 mm) and males, while 35% of routine ultrasound studies were performed for uncertain or inappropriate reasons.
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