The natural history of carotid bruits in elderly persons

Article Abstract:

Carotid bruits are sounds within the carotid artery, a major blood vessel supplying the head, and are often associated with cerebrovascular or brain circulation diseases. The risk for cerebrovascular events (strokes) was assessed in 241 elderly patients with an average age of 86 years. In the entire sample, 12 percent of subjects had carotid bruits without symptoms. The incidence of carotid bruits without symptoms was 8 percent in subjects 75 to 84 years old, 10 percent in those aged 85 to 94 years, and 13 percent in subjects aged 94 years and over. The incidence of cerebrovascular events in subjects with carotid bruits without symptoms was 10 percent as compared with 9 percent in subjects without carotid bruits. Carotid bruits had disappeared at the time of follow-up examination in 60 percent of subjects, and disappearance of carotid bruits was not associated with the occurrence of cerebrovascular events. The results show that the development of carotid bruits increases with age, but does not greatly increase the risk of stroke in the elderly. In addition, carotid bruits may disappear without any accompanying clinical changes. (Consumer Summary produced by Reliance Medical Information, Inc.)

Risk factors, Development and progression, Cerebrovascular disease, Cerebrovascular disorders

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Lack of effect of aspirin in asymptomatic patients with carotid bruits and substantial carotid narrowing

Article Abstract:

Aspirin may not have a beneficial effect in the treatment of severe carotid stenosis, which is a narrowing of the main artery supplying the head and neck. Researchers observed the complications and deaths of 372 patients with an ultrasound diagnosed carotid stenosis of at least 50 percent who had no overt symptoms. A total of 188 patients took 325 milligrams of aspirin every day for an average of 2.3 years. The control group, consisting of 184 patients, took a placebo. Both groups were very similar with respect to clinical outcome, such as stroke, heart attack, unstable angina, and death. The aspirin group had adverse outcomes at an annual rate of 11%, while the control group had a rate of 12.3%. Side effects were restricted to a few cases of stomach upset. Aspirin may have a temporary effect early in the disease.

Health aspects, Drug therapy, Aspirin, Arteries, Arterial stenosis

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Predictive power of duplex ultrasonography in asymptomatic carotid disease

Article Abstract:

Periodic duplex ultrasonography does not appear to be a useful means of predicting transient ischemic attacks (TIAs) or stroke in symptom-free patients with narrowed carotid arteries. Researchers examined the carotid arteries via duplex ultrasonography twice a year for an average of 3 years in 715 patients with narrowed carotid arteries. Sixty-one TIAs and 38 strokes occurred. The majority of strokes occurred in patients who did not have severe narrowing. Although progressive narrowing of the arteries was associated with increased risk of a TIA or stroke, the association was too weak to justify the cost of repeated testing.

Diagnosis, Duplex ultrasonography

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