Ten year cerebrovascular morbidity and mortality in 68 year old men with asymptomatic carotid stenosis

Abstract Objective: To study the natural course of carotid artery stenosis detected by ultrasonography. Design: Prospective cohort study. Baseline examination in 1982-3 included ultrasound examination of carotid arteries, measurement of anklebrachial blood pressure index, and detection of atrial fibrillation by 24 hour ambulatory electrocardiography. Setting: Malmo, a city in southern Sweden with 230000 inhabitants. Subjects: 470 men aged 68 years randomly selected from the population. Main outcome measures: Incidence of stroke and transient ischaemic attack and all cause mortality during 10 years of follow up in relation to carotid stenosis, leg artery disease (ankle-brachial blood pressure index below 0.9), and atrial fibrillation. Results: Fifty men had a stroke; six of these were haemorrhagic. Another 11 had a transient ischaemic attack. Eighteen of the men with carotid stenosis (21.6 events/1000 person years) and 43 of the men with normal carotid arteries (14.8 events/1000 person years) had a stroke or transient ischaemic attack (P=0.188). Men with atrial fibrillation had an increased rate of cerebrovascular events (36.7/1000 person years (P=0.048). The highest rate was found in men with asymptomatic disease of the leg arteries (38.6/1000 person years) (P