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Carotid Stenosis as Detected by Ultrasound in a General Population is a Strong Predictor of Death
Author(s) -
Joakimsen* Oddmund,
Bønaa† Kaare H.,
Mathiesen*† Ellisiv
Publication year - 2001
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1034/j.1600-0404.2001.103005327.x
Subject(s) - medicine , stenosis , stroke (engine) , cardiology , population , relative risk , risk factor , cause of death , disease , confidence interval , environmental health , mechanical engineering , engineering
Background and Purpose: In the last two decades, ultrasound examinations have increasingly been used as a noninvasive method to screen for carotid stenosis. Several clinical studies have shown that carotid stenosis is a risk factor for ischemic stroke and coronary heart disease and death. However, there is scarce information about stenosis as detected in a general population and the relation with mortality. The purpose of this population‐based study was to assess whether carotid stenosis is a predictor of death.Methods:In 1994 to 1995, 248 subjects with suspected carotid stenosis were identified among 6727 men and women 25 to 84 years of age who were examined with ultrasound as part of the population‐based Tromsø Study. These subjects and 496 age‐ and sex‐matched control subjects were followed for 4.2 years, and the number and causes of deaths were identified.Results:The unadjusted relative risk for death was 2.72 (95% CI, 1.57 to 4.75) for subjects with stenosis compared with control subjects. Adjusting for cardiovascular risk factors increased the relative risk to 3.47 (95% CI, 1.47 to 8.19). The adjusted relative risk in persons with stenosis and no cardiovascular disease or diabetes was 5.66 (95% CI, 1.53 to 20.90), which was higher than in subjects with stenosis and self‐reported disease (1.79; 95% CI, 0.75 to 4.27). There was a dose‐response relationship between degree of stenosis and risk of death ( P =0.002 for linear trend).Conclusion:Carotid stenosis as detected in a general population is a strong and independent predictor of death. Carotid stenosis was a stronger predictor of death than self‐reported cardiovascular disease or diabetes.