WINSTON-SALEM, N.C. -- An ultrasound test of the arteries in the neck may help doctors pick out which patients need aggressive treatment to prevent heart attacks or strokes, according to new findings published in the Jan. 7 issue of the New England Journal of Medicine.
Researchers found that the increasing thickness of the walls of the common carotid and internal carotid arteries of the neck -- a direct measure of atherosclerosis (hardening of the arteries) -- was associated with increased rate of heart attack and stroke.
Gregory L. Burke, M.D., principal investigator at the Wake Forest University Baptist Medical Center for the Cardiovascular Health Study (CHS), said that the finding held true even when the researchers adjusted for all of the traditional risk factors for heart attack and stroke, such as smoking, high cholesterol and high blood pressure.
"Elevation of heart disease risk factors is more common in the elderly," Burke explained. "It may be difficult for clinicians to identify older patients with cardiovascular disease who don't have symptoms solely on the basis of classic risk factors."
The ultrasound measurements of the carotids, which is non-invasive, appears to provide additional information needed to "help identify asymptomatic persons who would benefit from aggressive prevention measures," he said.
Such aggressive measures might include lowering high blood pressure or high cholesterol levels further than in other patients, more strict control of diabetes, and perhaps medical or surgical intervention.
Beginning in 1989, the Cardiovascular Health Study enrolled 5,201 men and women over the age of 65 in Forsyth County (Winston-Salem), N.C., Washington County (Hagerstown), Md., Allegheny County (Pittsburgh) Pa., and Sacramento County, Calif. All those who have survived are now at least 72, with some as old as 100.