Abstract Body: Introduction: Stroke ranks as the second leading cause of death globally and the foremost in China, contributing significantly to the nation’s disease burden. Carotid atherosclerosis (CAS) is a critical precursor to atherosclerotic cardiovascular disease and is closely associated with the development and progression of conditions such as stroke and poor prognosis. Despite its importance, data on the prevalence of CAS among adults (age 18 years and above) remain limited. This study aimed to determine the current prevalence of CAS and examine the associated gender differences in adults.
Methods: From September 2021 to June 2022, we established a prospective cohort to study CAS and cardiovascular disease across 25 project sites in Henan, China, utilizing a multistage whole-population sampling method. Residents aged 18 years or older in the sampled areas were included in this study, and data were collected through questionnaires, physical examinations, laboratory tests, carotid ultrasound examinations, and biological sample collection. A consent information platform for data collection and quality control management was also developed. This study was approved by the Ethics Committee for Scientific Research and Clinical Trials of the First Affiliated Hospital of Zhengzhou University (No. 2021-KY-1289-001).
Results: Among the 36,403 participants (14,676 males, 40.3%), the prevalence of stroke, heart disease, hypertension, diabetes mellitus, and dyslipidemia was 7.4%, 6.4%, 55.7%, 17.3%, and 40.2% respectively. After age standardization, the prevalence of cIMT, carotid plaque, and carotid stenosis was 23.24%, 16.75%, and 2.36%, respectively, with moderate to severe carotid stenosis observed in 0.49% of all participants. Additionally, the gender-stratified analysis revealed that carotid atherosclerosis was more severe in males, who exhibited higher rates of cIMT, plaque, stenosis, and moderate to severe stenosis compared to females (41.20% vs. 31.37%, 38.91% vs. 27.11%, 5.08% vs. 3.04%, and 1.49% vs. 0.69%, respectively).
Conclusions： In conclusion, our study highlights that intima-media thickening and plaques are more prevalent in adult carotid arteries, with a significantly higher prevalence in males. These findings provide valuable evidence for authorities to implement health policies and identify high-risk populations, aiming to prevent the occurrence of stroke in both the general population and high-risk groups.