Clinical Significance of Carotid Artery Plaque with Age and Sex

A US cohort study suggests that carotid artery plaque (CAP) becomes very common with increasing age among individuals without clinical atherosclerotic cardiovascular disease (ASCVD), and the association of CAP with incident ASCVD events was stronger in younger ages, especially among women. A total of 5689 participants with complete data were recruited from 2000-2002 and included in the analysis. The mean age was 62.0 years, and 53% female; 27% Black, 12% Chinese, 22% Hispanic, and 38% White. There were 1043 ASCVD events over a median period of 17.6 years. Prevalence of CAP differed by age, sex, race, and ethnicity, ranging from 15% in Chinese women younger than 50 years to 95% in non-Hispanic White men aged 80 to 84 years. CAP independently predicted ASCVD events (hazard ratio, 1.38). The association was stronger among younger participants (≤60 years) vs older (>60 years), especially among women vs men. CAP detection in younger participants conferred higher relative ASCVD risk than in older participants, who had higher absolute risk regardless of CAP. The findings indicate that younger individuals, particularly younger women, have the larger relative risk associated with CAP, although older individuals have the higher absolute risk of ASCVD. Source:  https://jamanetwork.com/