Carotid intima-media thickness as a screening tool in cardiovascular primary prevention


Antonio L. Aguilar-Shea, C/Clara del Rey No 58 1D, 28002 Madrid, España. Tel.: +34 91458 7840; fax: +34 63594 0167;


Eur J Clin Invest 2011; 41 (5): 521–526


Background and Objective  Increased carotid intima-media thickness (CIMT) is associated with cardiovascular events. The purpose of this study was to identify advanced subclinical atherosclerosis in patients who are at low or intermediate risk.

Methods  Thousand hundred and eighteen Spanish subjects were prospectively enrolled in an ambulatory screening of cardiovascular risk (CVR). Three hundred and twenty patients aged over 30 years with low-intermediate CVR according to European SCORE function underwent carotid ultrasonography. Carotid IMT and plaque assessment were performed using high-resolution B-mode ultrasonography. Participants with abnormal CIMT were reclassified to high CVR.

Results  According to SCORE function, 104 patients (32·5%) were of low CVR and 216 (67·5%) of intermediate CVR. Mean carotid IMT was 0·62 ± 0·13 mm, and carotid plaque was found in 35 (10·9%) patients. Carotid ultrasonography changed the risk stratum in 59 (18·4%) patients, who were reclassified to high CVR. Reclassification was more frequent in the intermediate CVR group than in the low CVR group (22·7% vs. 9·6%, P = 0·005) and was associated to age (P = 0·002), history of arterial hypertension (P < 0·001) and increased systolic blood pressure (P = 0·05).

Conclusions  CIMT calculated by high-resolution B-mode ultrasonography could become an important tool in preventive medicine. Measuring CIMT may be useful in identifying asymptomatic individuals with subclinical atherosclerosis not detected by the actual CVR functions.