The prevalence of carotid subclinical atherosclerosis according to age: A systematic review and meta-analysis of the young to middle-age.

BACKGROUD: As the burden of atherosclerotic cardiovascular disease (ASCVD) continues to rise, knowing the prevalence of its subclinical form is essential for early risk stratification and prevention. This review investigated the prevalence of carotid subclinical atherosclerosis, defined by the presence of plaque detected by ultrasound of the carotid arteries, as it varies with age in the asymptomatic young to middle-aged general population. SOURCES OF MATERIAL: We searched MEDLINE, EMBASE, PubMed, and CENTRAL (2005-2023) databases for observational and experimental studies assessing population a of asymptomatic (ie, no known cardiovascular disease), individuals (aged 18-65 years) who underwent carotid artery ultrasound imaging. Prevalence of plaque was calculated from each included study, as well as based on age and sex subgroups, and Freeman-Tukey double-arcsine-transformed prevalence measures were computed for each study. Pooled measures were generated with a random-effects meta-analysis model. ABSTRACT OF FINDINGS: A total of 92 studies comprising 204,997 subjects were included in this review (median sample size: 859). The median age of the study sample was 49.5 years (range: 26.6-64 years). The overall pooled prevalence of carotid atherosclerosis across all studies was 23% (95% CI: 19.1%-27.1%). The prevalence of carotid plaque increased according to age, ranging from a pooled prevalence of 5.2% (95% CI: 2.4%-8.9%) in adults aged 18 to 45 years to 30.3% (95% CI: 21.8%-39.4%) in those aged 50 to 65 years. CONCLUSION: Subclinical carotid atherosclerosis is prevalent among young to middle-aged healthy adults, free of known CVD, from the general population. The findings suggest that a significant proportion of low-risk individuals may have undetected plaque, justifying reconsideration of early screening strategies.

Duke Scholars

Author Pamela Susan Douglas Medicine, Cardiology