Epidemiology

One systematic review and meta-analysis estimated the global prevalence of carotid stenosis in people aged 30-79 years in 2020 to be 1.5%.[3]​ The estimated global prevalences of increased carotid intima-media thickness and carotid plaque were 27.6% and 21.1%, respectively.[3] Compared with the year 2000, the prevalence of carotid stenosis had increased by 59.13%, with the greatest increase in those aged 50-59 years. The prevalence of carotid stenosis, increased carotid intima-media thickness, and carotid plaque increased with older age, and was higher in men than in women. In another systematic review, asymptomatic carotid artery stenosis was estimated to affect approximately 7% of women and 12% of men aged >70 years.[4]​ In a study in the US, high-grade asymptomatic carotid stenosis (≥70% stenosis) was found to occur in approximately 1.0% of men and 0.6% of women aged 75 years and over.[5]

Approximately 10% to 15% of all ischaemic strokes are associated with carotid artery stenosis, and carotid-related strokes are commonly disabling or fatal. About one third of strokes are thromboembolic in aetiology, and atherosclerotic carotid stenosis is the most common single cause.[6]

In the Northern Manhattan Study, between 1993 and 1996, stroke attributable to carotid stenosis occurred in 17 in 100,000 (95% CI 8 to 26) black people, 9 in 100,000 (95% CI 5 to 13) Hispanic people, and 5 in 100,000 (95% CI 2 to 8) white people.[7]

In a pooled study of stroke centres in Germany, carotid artery stenosis was the cause in 20.9% of stroke patients.[8] In a London-based population in the UK, carotid stenosis was deemed the cause of ischaemic stroke or transient ischaemic attack in 7.9% of patients presenting to hospital, and was deemed asymptomatic in another 11%.[9] Asymptomatic carotid artery stenosis affects approximately 7% of women and 12% of men aged >70 years.[4]

Stroke is one of the leading causes of death and disability worldwide.​ In the US, each year approximately 795,000 people experience a new or recurrent stroke, with 610,000 of these being first attacks and 185,000 recurrent attacks.[10]​ In 2021, 162,890 deaths were attributable to stroke.[10]​ In the UK, there are more than 100,000 strokes every year.[11]​​

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