Abstract 1902: Prevalence Of Atherosclerosis in Middle-age: Results from the Asklepios Study in 2524 Subjects Free from Overt Cardiovascular Disease
Background: Ultrasonographic atherosclerosis phenotypes are currently advocated as intermediate phenotypes in risk prediction, in clinical trials and in biomarker discovery. Nevertheless data on the prevalence of atherosclerotic phenotypes such as intima-media thickening (IMT>0.9mm) or plaque at different sites (carotid, femoral) within single population databases are limited.
Methods: The 2524 participants (1301 F) of the ASKLEPIOS Study are a representative cohort of 35–55 year-old subjects (median age 45.9 y) free from overt cardiovascular disease at baseline. Extensive physical and laboratory evaluations included echography (GE/Vingmed Vivid 7; all single observer, device and site). Phenotypes studied include: IMT, plaque (Mannheim criteria) at both carotid and femoral arteries.
Results: Using conservative definitions (limiting IMT measurement to high-shear areas): 40% of subjects had atherosclerosis (femoral 30%; carotid 22%) with obvious age/gender dependency (see fig⇓.). Males have a prevalence increase of 20%/5 years; females of 10%/5 years. Prevalence data are highly dependent on the definition used, using less conservative definitions including low shear areas of the vasculature for IMT measurement would dramatically increase prevalence of atherosclerosis to >80% even in subjects <40 years.
Conclusions: Ultrasound evidence for atherosclerosis (IMT or plaque) is very common in apparently healthy 35–55 year old subjects, with pronounced age and gender gradients. Expanding current definitions of atherosclerosis to include low-shear wall thickening yields prevalence data effectively invalidating its discriminative use as a risk marker.