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The Prevalence of Carotid Artery Stenosis Varies Significantly By Race
Caron Rockman, MD, Thomas Maldonado, MD, Glenn R. Jacobowitz, MD, Jeffrey S. Berger, MD, Mark A. Adelman, MD, Thomas S. Riles, MD.
New York University Medical Center, New York, NY, USA.

OBJECTIVES: Certain races are known to be at increased risk for stroke, and the prevalence of carotid artery stenosis (CAS) is thought to vary by race. The goal of this report was to study the prevalence of CAS by race via analysis of a large population of patients who underwent vascular screening examinations.
METHODS: Of 3.494.778 patients who underwent voluntary vascular screening, 3.7% did not self-identify a race and were excluded. Analysis of collected data was performed by gender and by age. CAS was defined to be present when > 50% by Duplex criteria.
RESULTS: The 3.561,679 patients consisted of Caucasians (C, n=3,166,432, 88.9%), African-Americans (AA, n=111,456, 3.1%), Hispanics (H, n=87,615, 2.5%),Asians (A, n=71,198, 2.0%, and Native Americans (NA, n=102,162, 2.9%). Controlling for gender and age, there was marked variation in the prevalence of CAS (p<0.001). In males of all ages, NA's had the highest rate of CAS, and C's had the second highest rate. Male AA patients had either the lowest rate, or the second lowest rate in all age cagegories studied. In female patients of all ages, NA's again had the highest rate of CAS, with C's having the second highest rate. However, in contrast to males, A females uniformly had the lowest prevalence of CAS. Multivariate analysis including atherosclerotic and demographic factors confirmed race as an independent predictive variable.
CONCLUSIONS: The prevalence of CAS varies significantly by race. NA and C patients have the highest rates of CAS, while AA males and A females appear to have the lowest rates. This information adds evidence to the hypothesis that the increased stroke rate in AA patients is likely not lrelated to extracranial cerebrovascular disease. Furthermore, this is an ovel report of an extremely high rate of CAS in NA patients.
Relationship of carotid artery stenosis and race
CaucasianAfrican AmericanHispanicAsianNative American
Males 51-601.8%1.1%1.2%1.1%2.3%
Males 61-704.1%2.6%2.8%3.1%5.4%
males 71-807.2%4.7%5.5%5.0%9.8%
Males > 8110.8%7.3%9.2%6.5%12.5%
Females 51-601.7%1.3%1.1%1.1%2.6%
Females 61-703.3%2.6%2.3%2.1%4.6%
Females 71-805.6%4.3%4.5%3.4%6.7%
Females > 817.6%6.7%7.0%4.7%8.3%


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