Abstract
BackgroundAtherosclerosis is a chronic progressive disease often presenting as clinical cardiovascular disease (CVD) events. This study evaluated the characteristics of individuals with a diagnosis of atherosclerosis and estimated the incidence of CVD events to assist in the early identification of high-risk individuals.MethodsRespondents to the US SHIELD baseline survey were followed for 2 years to observe incident self-reported CVD. Respondents had subclinical atherosclerosis if they reported a diagnosis of narrow or blocked arteries/carotid artery disease without a past clinical CVD event (heart attack, stroke or revascularization). Characteristics of those with atherosclerosis and incident CVD were compared with those who did not report atherosclerosis at baseline but had CVD in the following 2 years using chi-square tests. Logistic regression model identified characteristics associated with atherosclerosis and incident events.ResultsOf 17,640 respondents, 488 (2.8%) reported having subclinical atherosclerosis at baseline. Subclinical atherosclerosis was associated with age, male gender, dyslipidemia, circulation problems, hypertension, past smoker, and a cholesterol test in past year (OR = 2.2) [all p < 0.05]. Incident CVD was twice as high in respondents with subclinical atherosclerosis (25.8%) as in those without atherosclerosis or clinical CVD (12.2%). In individuals with subclinical atherosclerosis, men (RR = 1.77, p = 0.050) and individuals with circulation problems (RR = 2.36, p = 0.003) were at greatest risk of experiencing CVD events in the next 2 years.ConclusionSelf-report of subclinical atherosclerosis identified an extremely high-risk group with a >25% risk of a CVD event in the next 2 years. These characteristics may be useful for identifying individuals for more aggressive diagnostic and therapeutic efforts.
Highlights
Atherosclerosis is a chronic progressive disease often presenting as clinical cardiovascular disease (CVD) events
[2] Subclinical atherosclerosis is a latent precursor of clinical CVD, including myocardial infarction (MI) and stroke. [3]
The Healthy People 2010 initiative and the Public Health Action Plan to Prevent Heart Disease and Stroke call for improving cardiovascular health through prevention, detection, and treatment of risk factors, as well as prevention of recurrent CVD events. [4,5,6] The American Heart Association (AHA) guidelines for primary and secondary prevention of atherosclerotic CVD provide evidence and recommendations to assist clinicians in managing and treating atherosclerosis. [7,8,9] evidence is limited on identifying individuals with subclinical atherosclerosis before a CVD event occurs, especially since specialized diagnostic imaging is not part of routine clinical practice
Summary
Atherosclerosis is a chronic progressive disease often presenting as clinical cardiovascular disease (CVD) events. This study evaluated the characteristics of individuals with a diagnosis of atherosclerosis and estimated the incidence of CVD events to assist in the early identification of high-risk individuals. [2] Subclinical atherosclerosis is a latent precursor of clinical CVD, including myocardial infarction (MI) and stroke. [7,8,9] evidence is limited on identifying individuals with subclinical atherosclerosis before a CVD event occurs, especially since specialized diagnostic imaging is not part of routine clinical practice. The purpose of the present study was to evaluate the self-reported characteristics and estimate the incidence of CVD events among individuals with subclinical atherosclerosis to assist in the early identification of high-risk individuals
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