Carotid intima-media thickness as a screening tool in cardiovascular primary prevention.

Background and Objective:   Increased carotid intima-media thickness (CIMT) is associated with cardiovascular events. The purpose of this study was to identify advanced subclinical atherosclerosis in patients who are at low or intermediate risk.
Methods: Thousand hundred and eighteen Spanish subjects were prospectively enrolled in an ambulatory screening of cardiovascular risk (CVR). Three hundred and twenty patients aged over 30 years with low-intermediate CVR according to European SCORE function underwent carotid ultrasonography. Carotid IMT and plaque assessment were performed using high-resolution B-mode ultrasonography. Participants with abnormal CIMT were reclassified to high CVR.
Results: According to SCORE function, 104 patients (32·5%) were of low CVR and 216 (67·5%) of intermediate CVR. Mean carotid IMT was 0·62 ± 0·13 mm, and carotid plaque was found in 35 (10·9%) patients. Carotid ultrasonography changed the risk stratum in 59 (18·4%) patients, who were reclassified to high CVR. Reclassification was more frequent in the intermediate CVR group than in the low CVR group (22·7% vs. 9·6%, P = 0·005) and was associated to age (P = 0·002), history of arterial hypertension (P < 0·001) and increased systolic blood pressure (P = 0·05).
Conclusions: CIMT calculated by high-resolution B-mode ultrasonography could become an important tool in preventive medicine. Measuring CIMT may be useful in identifying asymptomatic individuals with subclinical atherosclerosis not detected by the actual CVR functions.
(© 2010 The Authors. European Journal of Clinical Investigation © 2010 Stichting European Society for Clinical Investigation Journal Foundation.)