Risk factors for carotid stenosis

risk factors

Risk factors for CAD are similar to those for atherosclerosis in other vascular beds.

High risk population for carotid atherosclerosis include:

• people with peripheral arterial disease
• people over 60 years with 3 cardiovascular risk factors
• those with coronary arterial disease
• those with aortic aneurismal disease
• people with contralateral symptomatic carotid atherosclerosis
• general European population over 60 years (1)

Framingham cohort study has reported that the following baseline risk factors predict the degree of stenosis over 12 years:

• age (odds ratio 1.6-1.7/10 year increase in age)
• cigarettes smoked (1.3-1.5 per 10 cigarettes smoked a day)
• systolic blood pressure (1.2 per 10 mm Hg increase)
• total cholesterol (1.1-1.2 per 0.5 mmol/L increase) (1).

Risk factors for the development of a stroke in carotid stenosis include:

• age
• hypertension
• coronary heart disease
• irregular and ulcerated plaque morphology
• absence of collateral flow
• impaired cerebral reactivity
• previous stroke or TIA
• microembolic signals observed on Transcranial Doppler (TCD) (2)

Reference:

• (1) Thapar A et al. Diagnosis and management of carotid atherosclerosis. BMJ. 2013;346:f1485.
• (2) Lovrencic-Huzjan A, Rundek T, Katsnelson M. Recommendations for management of patients with carotid stenosis. Stroke Res Treat. 2012;2012:175869.