The prognostic significance of asymptomatic carotid bruits in the elderly

Ronald I. Shorr, Karen Johnson, Jim Wan, Kim Sutton-Tyrrell, Marco Pahor, James Bailey, William B. Applegate

Research output: Contribution to journalArticle

19 Citations (Scopus)

Abstract

OBJECTIVE: To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN: Retrospective cohort study. SETTING: The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in non- institutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS: The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4%) of the participants at baseline. Strokes developed in 21 (7.4%) of those with carotid bruits and in 210 (5.0%) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95% confidence interval [CI] 0.98. 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95% CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p = .08) toward increased risk (relative risk [RR] 2.05; 95% CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95% CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS: Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated systolic hypertension aged 70 years or older is limited.

Original languageEnglish (US)
Pages (from-to)86-90
Number of pages5
JournalJournal of General Internal Medicine
Volume13
Issue number2
DOIs
StatePublished - Mar 12 1998

Fingerprint

Stroke
Hypertension
Confidence Intervals
Institutionalization
Transient Ischemic Attack
Random Allocation
Aspirin
Cohort Studies
Retrospective Studies
Smoking
Myocardial Infarction
Blood Pressure
Lipids

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

The prognostic significance of asymptomatic carotid bruits in the elderly. / Shorr, Ronald I.; Johnson, Karen; Wan, Jim; Sutton-Tyrrell, Kim; Pahor, Marco; Bailey, James; Applegate, William B.

In: Journal of General Internal Medicine, Vol. 13, No. 2, 12.03.1998, p. 86-90.

Research output: Contribution to journalArticle

Shorr, Ronald I. ; Johnson, Karen ; Wan, Jim ; Sutton-Tyrrell, Kim ; Pahor, Marco ; Bailey, James ; Applegate, William B. / The prognostic significance of asymptomatic carotid bruits in the elderly. In: Journal of General Internal Medicine. 1998 ; Vol. 13, No. 2. pp. 86-90.
@article{b1d66732821d47d8a3edc14f16770847,
title = "The prognostic significance of asymptomatic carotid bruits in the elderly",
abstract = "OBJECTIVE: To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN: Retrospective cohort study. SETTING: The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in non- institutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS: The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4{\%}) of the participants at baseline. Strokes developed in 21 (7.4{\%}) of those with carotid bruits and in 210 (5.0{\%}) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95{\%} confidence interval [CI] 0.98. 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95{\%} CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p = .08) toward increased risk (relative risk [RR] 2.05; 95{\%} CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95{\%} CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS: Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated systolic hypertension aged 70 years or older is limited.",
author = "Shorr, {Ronald I.} and Karen Johnson and Jim Wan and Kim Sutton-Tyrrell and Marco Pahor and James Bailey and Applegate, {William B.}",
year = "1998",
month = "3",
day = "12",
doi = "10.1046/j.1525-1497.1998.00023.x",
language = "English (US)",
volume = "13",
pages = "86--90",
journal = "Journal of General Internal Medicine",
issn = "0884-8734",
publisher = "Springer New York",
number = "2",

}

TY - JOUR

T1 - The prognostic significance of asymptomatic carotid bruits in the elderly

AU - Shorr, Ronald I.

AU - Johnson, Karen

AU - Wan, Jim

AU - Sutton-Tyrrell, Kim

AU - Pahor, Marco

AU - Bailey, James

AU - Applegate, William B.

PY - 1998/3/12

Y1 - 1998/3/12

N2 - OBJECTIVE: To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN: Retrospective cohort study. SETTING: The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in non- institutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS: The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4%) of the participants at baseline. Strokes developed in 21 (7.4%) of those with carotid bruits and in 210 (5.0%) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95% confidence interval [CI] 0.98. 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95% CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p = .08) toward increased risk (relative risk [RR] 2.05; 95% CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95% CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS: Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated systolic hypertension aged 70 years or older is limited.

AB - OBJECTIVE: To determine the association between asymptomatic carotid bruits and the development of subsequent stroke in older adults with isolated systolic hypertension. DESIGN: Retrospective cohort study. SETTING: The Systolic Hypertension in the Elderly Program (SHEP), a 5-year randomized trial testing the efficacy of treating systolic hypertension in non- institutionalized persons aged 60 years or older. From the original 4,736 SHEP participants, we identified a cohort of 4,442 persons who had no prior history of stroke, transient ischemic attack, or myocardial infarction at randomization. MEASUREMENTS AND MAIN RESULTS: The end point for this ancillary study was the development of a stroke. The average follow-up was 4.2 years. Carotid bruits were found in 284 (6.4%) of the participants at baseline. Strokes developed in 21 (7.4%) of those with carotid bruits and in 210 (5.0%) of those without carotid bruits. The unadjusted risk of stroke among persons with carotid bruits was 1.53 (95% confidence interval [CI] 0.98. 2.40). Adjusting for age, gender, race, blood pressure, smoking, lipid levels, self-reported aspirin use, and treatment group assignment, the relative risk of stroke among persons with asymptomatic carotid bruits was 1.29 (95% CI 0.80, 2.06). Among SHEP enrollees aged 60 to 69 years, there was a trend (p = .08) toward increased risk (relative risk [RR] 2.05; 95% CI 0.92, 4.68) of subsequent stroke in persons with, compared to those without, carotid bruits. However, among enrollees aged 70 years or over, there was no relation between carotid bruit and subsequent stroke (RR 0.98; 95% CI 0.55, 1.76). In no other subgroup of SHEP enrollees did the presence of carotid bruit independently predict stroke. CONCLUSIONS: Although we cannot rule out a small increased risk of stroke associated with bruits in asymptomatic SHEP enrollees aged 60 to 69 years, the utility of carotid bruits as a marker for increased risk of stroke among asymptomatic elderly with isolated systolic hypertension aged 70 years or older is limited.

UR - http://www.scopus.com/inward/record.url?scp=0031939853&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0031939853&partnerID=8YFLogxK

U2 - 10.1046/j.1525-1497.1998.00023.x

DO - 10.1046/j.1525-1497.1998.00023.x

M3 - Article

VL - 13

SP - 86

EP - 90

JO - Journal of General Internal Medicine

JF - Journal of General Internal Medicine

SN - 0884-8734

IS - 2

ER -