We investigated the prevalence and associations with cardiovascular symptoms, signs, and risk factors of common carotid atherosclerosis using B-mode ultrasonography in a population sample of 182 eastern Finnish men aged 70 to 89 years. Men were examined in 1989 as a part of the 30-year follow-up examination of the eastern Finnish cohort of the Seven Countries Study. The mean maximal intima-media thickness (IMT) of the right and left common carotid arteries was 1.5 mm (range, 0.7 to 5.3 mm; standard deviation, 0.7 mm). Fifty-one percent of the subjects had nonmineralized atheroma and 91% had single or multiple mineralizations in any of the arterial segments imaged. Both mean maximal IMT and nonmineralized atheromas were associated significantly (P<.05) with the presence of cerebral atherosclerosis, carotid C ardiovascular diseases are very common in Finland, especially in middle-aged men. 1 The majority of cardiovascular diseases are of atherosclerotic origin. The occurrence of human atherosclerosis has traditionally been studied on the basis of either autopsies or invasive angiography. Therefore, it has not been possible to carry out studies in randomly selected population samples. High-resolution ultrasonography enables the noninvasive imaging and quantitative assessment of both early and advanced atherosclerotic lesions in superficial large and medium-sized arteries.Ultrasonographic assessment of atherosclerosis has been applied in population samples in studies of occurrence and risk factors of early atherosclerosis. 211 The prevalence of asymptomatic carotid atherosclerosis in elderly populations is, however, not well known.
-10Ultrasonographically assessed carotid atherosclerosis has predicted the risk of coronary events in middle-aged men. and symptoms of coronary heart disease (CHD) and cerebrovascular disease in the elderly.12 Prospective population studies indicate that the impact of the major coronary risk factors, smoking, elevated serum cholesterol concentration, and hypertension, is attenuated in the elderly. 13 There are no previous reports from prospective studies on the association of risk factors assessed in middle age and later in life with the occurrence of carotid atherosclerosis in old age.The purpose of the present study was to investigate the prevalence of different manifestations of B-mode ultrasonographically assessed cases of common carotid atherosclerosis and their associations with cardiovascular symptoms and signs assessed at the same time and with past and present levels of the major cardiovascular risk factors in elderly eastern Finnish men.
Methods
Study PopulationIn 1959, all 1711 men aged 40 to 59 years, living in two rural areas in eastern and southwestern Finland, were invited to take part in a prospective study of CHD and other atherosclerotic diseases, the Seven Countries Study. 1415 In this original study cohort 823 men were from eastern Finland and 888 men were from southwestern Finland. The 30-year follow-up examination of surviving men was performed in 1989, wh...