Prevalence of carotid atherosclerosis in 3-92-year-old Finns. The 3-generational cardiovascular risk in young Finns study

Abstract

Background and aims: Population based data are limited on the prevalence of carotid atherosclerosis across broad age-ranges from early childhood to old age. We aimed to determine the prevalence and determinants of carotid artery plaques in a Finnish population.

Methods: We examined carotid arteries using ultrasound in 6692 participants from the 3-generational Young Finns Study (age 3-92 years; 56.6 % female).

Results: Carotid plaques were detected beginning from the age of 18 years. In adults aged 18-92 years, the overall prevalence was 48.2 % (men 51.7 %, women 45.7 %). The prevalence increased by age groups, being ∼5 % under age of 30, ∼30 % between ages 30 and 50, ∼60 % between ages 50 and 70, and ∼90 % above age 70. Plaques were predominantly found in the carotid bifurcation and in the internal carotid artery. High LDL-cholesterol (≥3.4 mmol/L or ≥130 mg/dL) and hypertension were strong risk factors for plaques especially among young adults under the age of 40. Despite this, about 40 % of young adults who had a plaque were not identified by these conventional risk factor assessments. The prevalence of clinical cardiovascular disease was 2.2 % among individuals without plaque vs. 18.9 % among those with plaque (age and sex adjusted risk ratio 2.2 95 %CI 1.7-2.9).

Conclusions: Carotid artery plaques are very prevalent finding among Finnish adults but not observed in children of the general population. High LDL-cholesterol concentration and hypertension are strongly associated with plaques, especially among young adults. On the other hand, these data demonstrate that a substantially large proportion of young and middle-aged adults with plaques cannot be identified by the assessment of conventional risk factors.

Keywords: Carotid plaques; Cohort studies; Epidemiology; Pre-clinical atherosclerosis; Risk factors; Vascular ultrasound.