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Prevalence and Burden of Carotid and Femoral Atherosclerosis in Subjects Without Known Cardiovascular Disease in a Large Community Hospital in South-America

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Abstract

Introduction

Clinical guidelines recommend measurement of arterial (carotid and femoral) plaque burden by vascular ultrasound (VUS) as a risk modifier in individuals at low or moderate risk without known atherosclerotic cardiovascular disease (ASCVD).

Aim

To evaluate the prevalence of carotid and femoral plaques by age and sex, the burden of subclinical atherosclerosis (SA), and its association with classic CVRF in subjects over 30 years of age without ASCVD.

Methods

We prospectively enrolled 5775 consecutive subjects referred for cardiovascular evaluation and determined the prevalence and burden of SA using 2D-VUS in carotid and femoral arteries.

Results

Sixty-one percent were men with a mean age of 51.3 (SD 10.6) years. Overall, plaque prevalence was 51% in carotid arteries, 39.3% in femoral arteries, 62.4% in carotid or femoral arteries, and 37.6% in neither. The prevalence of plaques and SA burden showed an increasing trend with age, being higher in men than in women and starting before the age of 40, both in the carotid and femoral sites. There was also an increasing prevalence of plaques according to the number of CVRF, and interestingly we found a high prevalence of plaques in subjects with 0 or 1 classic CVRF.

Conclusions

We observed an increased prevalence and burden of carotid or femoral SA, higher in men, beginning before the fourth decade of life and increasing with age. Despite a significant association with classic CVRF, a significant number of subjects with low CVRF were diagnosed with SA.

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Acknowledgements

The authors thank the participants in this study and the administrative and medical staff of the Hypertension and Vascular Ageing Unit, Hospital Universitario Austral.

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This work had no funding support.

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Authors and Affiliations

  1. Clinical Research Unit, Instituto Cardiovascular de Buenos Aires (ICBA), Av del Libertador 6302, Buenos Aires, Argentina

    Fernando Botto

  2. Hypertension and Vascular Ageing Unit, Hospital Universitario Austral, Pilar, Buenos Aires, Argentina

    Fernando Botto, Sebastian Obregon, Pedro Forcada, Ana Di Leva, Gabriela Fischer Sohn, Joon-Ho Bang, Martin Koretzky, Sergio Baratta & Carol Kotliar

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Contributions

FB, SO, PF and CK contributed to conception, design, data acquisition and analysis, interpretation of results, review and editing. ADL, GFS, JB, MK and SB contributed to data acquisition, interpretation of results, review and editing. FB drafted the first manuscript and all authors reviewed subsequent versions and approved the final version.

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Correspondence to Fernando Botto.

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Botto, F., Obregon, S., Forcada, P. et al. Prevalence and Burden of Carotid and Femoral Atherosclerosis in Subjects Without Known Cardiovascular Disease in a Large Community Hospital in South-America. High Blood Press Cardiovasc Prev 31, 177–187 (2024). https://doi.org/10.1007/s40292-024-00627-3

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