Epidemiology of atherosclerotic carotid artery disease

Semin Vasc Surg. 2021 Mar;34(1):3-9. doi: 10.1053/j.semvascsurg.2021.02.013. Epub 2021 Feb 12.

Abstract

Atherosclerotic carotid artery disease is a significant cause of stroke in the United States and globally. Its prevalence increases with age and it is more prevalent in men and White and Native-American populations. However, the outcomes related to carotid disease are worse in women and Black patients. Research suggests the disparities exist due to a multitude of factors, including disease pathophysiology, access to care, provider bias, and socioeconomic status. The prevalence of carotid stenosis in the general population is low (3%), and routine screening for carotid stenosis is not recommended in adults. Randomized clinical trials have shown benefits of stroke risk reduction with surgery (carotid endarterectomy or stenting) for symptomatic patients. Management is controversial in asymptomatic patients, as modern medical management has results equivalent to those of surgery and ongoing randomized clinical trials will address this important question. Carotid surgery is not appropriate in asymptomatic patients with limited life expectancy. Future work should explore comprehensive care models for care of patients with carotid disease and assessment of patient-reported outcomes to measure quality of care.

Publication types

  • Review

MeSH terms

  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Carotid Artery Diseases / diagnostic imaging
  • Carotid Artery Diseases / epidemiology*
  • Carotid Artery Diseases / therapy
  • Female
  • Health Status Disparities
  • Healthcare Disparities
  • Humans
  • Male
  • Middle Aged
  • Prevalence
  • Prognosis
  • Race Factors
  • Risk Assessment
  • Risk Factors
  • Sex Factors
  • Stroke / diagnosis
  • Stroke / epidemiology*
  • Stroke / prevention & control
  • United States / epidemiology