Analysis of the population at high risk of stroke detected with carotid artery ultrasonography in Tianjin urban communities

Abstract

Objective To investigate the features of carotid atherosclerosis in a population at high risk of stroke in urban communities of Tianjin, so as to provide inspiration for carotid ultrasonography to play a greater role in the prevention and control of stroke.  Methods A total of 956 residents at high risk of stroke were selected from 4 urban communities in Tianjin using cluster random sampling method. Doppler ultrasound screening was performed in bilateral common carotid artery (CCA), internal carotid artery (ICA), external carotid artery (ECA), vertebral artery (VA), subclavian artery (SCA) and innominate artery of the population. The intima-media thickness (IMT), atherosclerotic plaque formation and its location and size, vascular stenosis or occlusion, and flow spectrum were detected. The results and features of carotid ultrasound screening were analyzed and compared among different gender and age groups.  Results 1) The detection rate of carotid atherosclerosis was 71.55% (684/956), and the detection rate in males was significantly higher than that in females (79.08% vs 65.87%; χ² = 20.067, P = 0.000). 2) Among the population with carotid atherosclerosis, the most common manifestation was the formation of atherosclerotic plaques (81.58%, 558/684), secondly intima-media thickening (13.01%, 89/684), followed by moderate to severe stenosis or occlusion (5.41%, 37/684). The proportion of intima-media thickening in males was lower than that in females (7.08% vs 18.38%; χ² = 19.269, P = 0.000). The proportion of carotid atherosclerotic plaque formation in males was higher than that in females (86.46% vs 77.16%; χ² = 9.824, P = 0.002). The median rating of carotid atherosclerosis was 1.79, with males higher than females [1.98 (0.70, 3.26) vs 1.52 (0.20, 2.84); Z = 2.304, P = 0.042]. The site of plaque formation was most commonly located in carotid bulb (36.61%), secondly SCA (22.18%). Of the type of carotid stenosis, ICA stenosis was detected in 30 cases, VA stenosis in 4 cases, VA occlusion in 3 cases, and subclavian steal syndrome (SSS) in 10 cases. 3) The detection rate of carotid atherosclerosis increased with age (χ² = 212.067, P = 0.000). The detection rate of intima-media thickening in the population aged less than 70 years was higher than that aged over 70 years (10.68% vs 6.03% ; χ² = 5.101, P = 0.024). The detection rate of carotid atherosclerotic plaque of the population aged over 60 years was significantly higher than that aged less than 60 years (72.26% vs 28.99%; χ² = 64.850, P = 0.000). Similarly, the detection rate of moderate to severe stenosis or occlusion in the population aged over 60 years was significantly higher than that aged less than 60 years (5.24% vs 0.98%; χ² = 10.174, P = 0.001). Conclusions The incidence of carotid atherosclerosis in the population at high risk of stroke is high in urban communities of Tianjin, and the incidence of males is higher than that of females, increasing with age. It is an simple, non-invasive, accurate, reliable, and effective measure to prevent stroke by using carotid artery ultrasound screening in the population at high risk of stroke.

DOI: 10.3969/j.issn.1672-6731.2015.04.005