Cardiovascular risk factors and signs of subclinical atherosclerosis in the Heinz Nixdorf Recall Study

Dtsch Arztebl Int. 2008 Jan;105(1-2):1-8. doi: 10.3238/arztebl.2008.0001. Epub 2008 Jan 7.

Abstract

Introduction: Modern investigation modalities allow markers of atherosclerosis to be detected at a subclinical stage. The aim of the study was to analyze the prevalence of these markers in relation to traditional risk factors.

Methods: The population based study included 4814 participants, aged 45 to 75 years, with a response rate of 55.8% of those contacted. The patients' history, psychosocial and environmental risk factors were assessed.

Results: The prevalence of obesity was 26.2% in men and 28.1% in women, 26% of men and 21% of women were smokers. Hypertension was found in 46% of men and 31% of women, diabetes in 9.3% of men and 6.3% of women. Markers of subclinical peripheral arterial disease were found in 6.4% of men and 5.1% of women, of subclinical carotid artery disease in 43.2% and 30.7%, and of subclinical coronary artery calcification in 82.3% and 55.2%, respectively. The prevalence of coronary calcification measured using an Agatston Score >100 was in 40% in men and 15% in women, using a score >400, 16.8% and 4.5%, respectively.

Discussion: A high prevalence of subclinical atherosclerosis was found in the older population. The follow-up period will demonstrate whether the detection of markers of subclinical atherosclerosis will improve risk stratification beyond that offered by traditional risk factors.

Keywords: CT; EBCT; atherosclerosis; cardiovascular risk; carotid stenosis; peripheral arterial disease; ultrasound.