Prevalence and distribution of sub-clinical atherosclerosis by screening vascular ultrasound in low and intermediate risk adults: the New York physicians study.

Background: Many persons experiencing cardiovascular disease (CVD) events are not at high calculated CVD risk by Framingham risk score. The identification of carotid and femoral plaque has been associated with CVD events. In this study, the prevalence of plaques in adults at low and intermediate risk was examined.

Methods: Asymptomatic patients without CVD (n = 715; 43% women) were screened for carotid and femoral plaque using B-mode ultrasound.

Results: Significant predictors of plaque were male gender and age and, among women, dyslipidemia. Overall plaque prevalence was 32.8% among women and 40.5% among men aged 50 to 64 years. Among subjects with plaque in this age group, 56% of women and 31% of men had plaque exclusively in the femoral artery and would have been missed if only carotid ultrasound had been performed.

Conclusion: Ultrasound screening of the carotid and femoral arteries in a population with low and intermediate Framingham risk scores can identify potentially high risk subjects for whom intensive CVD risk factor modification may be appropriate.