{"product_id":"neck-artery-ultrasound-predicts-heart-risk-and-may-be-linked-to-cancer-a-15-year-study-of-10-597-adults","title":"Neck Artery Ultrasound Predicts Heart Risk and May Be Linked to Cancer: A 15-Year Study of 10,597 Adults","description":"\u003cp\u003eThis large study followed more than 10,000 adults aged 20 to 65 who had no signs of heart disease and used ultrasound of the neck (carotid) arteries to measure plaque buildup. Researchers found that advanced atherosclerosis could not be predicted from classic risk factors such as cholesterol, blood pressure, diabetes, smoking, family history, and body mass index. In the 40-65 age group, 6.8% of men and 2.2% of women developed advanced plaque during an average follow-up of about 6 years, and these changes were not explained by classic risk factors (P \u0026gt; 0.05). Men who developed cancer or a cardiovascular event had much higher plaque burden than men without either condition. Men with cancer and men with cardiovascular events had very similar risk profiles and plaque burden. The authors conclude that measuring carotid plaque burden gives good risk information in every age group. The authors conclude that repeat ultrasound every 3-5 years is advisable. The authors conclude that early statin treatment of advanced atherosclerosis improves the prognosis for cardiovascular disease and possibly for certain cancers.\u003c\/p\u003e\n\n\u003ch1\u003eNeck Artery Ultrasound Predicts Heart Risk and May Be Linked to Cancer: A 15-Year Study of 10,597 Adults\u003c\/h1\u003e\n\n\u003ch2\u003eTable of Contents\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003e\u003ca href=\"#ddn-key-points\"\u003eKey Points\u003c\/a\u003e\u003c\/li\u003e\n\n\u003cli\u003e\u003ca href=\"#background\"\u003eBackground: Why This Research Matters\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#methods\"\u003eHow the Study Was Conducted\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#plaque-measurement\"\u003eHow Plaque Was Measured and Classified\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#findings-baseline\"\u003eKey Findings: Plaque Burden by Age and Sex\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#findings-progression\"\u003eKey Findings: Who Developed Advanced Plaque During Follow-Up\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#findings-cancer\"\u003eKey Findings: Cancer, Cardiovascular Events, and Plaque Burden\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#treatment\"\u003eTreatment Given to High-Risk Participants\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#hypothesis\"\u003eThe Hypothesis: Microvascular Dysfunction, Heart Disease, and Cancer\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#implications\"\u003eWhat This Means for Patients\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#limitations\"\u003eLimitations: What the Study Could Not Prove\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#recommendations\"\u003eRecommendations\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#ddn-faq\"\u003eFrequently Asked Questions\u003c\/a\u003e\u003c\/li\u003e\n\u003cli\u003e\u003ca href=\"#source\"\u003eSource Information\u003c\/a\u003e\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003c!-- ddn:keypoints:start --\u003e\n\u003ch2 id=\"ddn-key-points\"\u003eKey Points\u003c\/h2\u003e\n\u003cul\u003e\n\u003cli\u003eIn a study of 10,597 adults aged 20-65 without heart disease symptoms, 3,813 people aged 40-65 with low or medium plaque risk were examined again, and which of them went on to develop advanced atherosclerosis could not be predicted from classic risk factors like cholesterol, blood pressure, diabetes, smoking, family history, and body mass index.\u003c\/li\u003e\n\u003cli\u003eIn the 40-65 age group, 6.8% of men and 2.2% of women developed advanced plaque over about six years, and these changes were not explained by classic risk factors.\u003c\/li\u003e\n\u003cli\u003eThe authors conclude that measuring carotid plaque burden gives good risk information in every age group and that repeat ultrasound every 3-5 years is advisable.\u003c\/li\u003e\n\u003cli\u003eMen who developed cancer or a cardiovascular event had much higher plaque burden than men without either condition, and their risk profiles were very similar.\u003c\/li\u003e\n\u003cli\u003eThe authors conclude that early statin treatment of advanced atherosclerosis improves the prognosis for cardiovascular disease and possibly for certain cancers.\u003c\/li\u003e\n\u003c\/ul\u003e\n\u003c!-- ddn:keypoints:end --\u003e\n\n\n\u003ch2 id=\"background\"\u003eBackground: Why This Research Matters\u003c\/h2\u003e\n\n\u003cp\u003eAtherosclerosis (hardening and narrowing of the arteries from fatty plaque buildup) is the most common cause of death in industrialized countries. It is a systemic disease, meaning it affects arteries throughout the entire body, not just one location.\u003c\/p\u003e\n\n\u003cp\u003eThe most common cardiovascular diseases caused by atherosclerosis are heart attacks, strokes, and peripheral arterial disease (PAD, reduced blood flow in the legs and arms). The small blood vessels can also be affected. When the small vessels of the heart are involved, this is called coronary microvascular dysfunction (poor function of the tiny blood vessels feeding the heart muscle).\u003c\/p\u003e\n\n\u003cp\u003eThere is growing evidence that cancer is also associated with atherosclerosis and impaired microcirculation (poor blood flow through the smallest vessels). In every age group, some people have a high plaque burden and rapid progression of disease within just a few years.\u003c\/p\u003e\n\n\u003cp\u003eUltrasound examination of the carotid artery (the large artery in the neck) can detect advanced disease in the subclinical stage. \"Subclinical\" means the disease is present but has not yet caused symptoms. Detecting it early allows treatment to begin sooner, which can improve the prognosis (the likely course and outcome of the disease).\u003c\/p\u003e\n\n\u003cp\u003eThe extent of disease can be easily determined by measuring plaque area, called total plaque area (TPA), and maximum plaque thickness using ultrasound. The aim of this study was to investigate the extent of atherosclerosis by sex and age group. The researchers also asked whether the individual course of the disease can be predicted. In addition, they compared classic risk factors and plaque burden in men who developed new cardiovascular events or cancer.\u003c\/p\u003e\n\n\u003cp\u003eFinally, the authors formulated a hypothesis about how microvascular dysfunction and atherosclerosis on the one hand, and cardiovascular disease and cancer on the other hand, could be related. A hypothesis is a proposed explanation that needs further testing.\u003c\/p\u003e\n\n\u003ch2 id=\"methods\"\u003eHow the Study Was Conducted\u003c\/h2\u003e\n\n\u003cp\u003eThis was a retrospective study, meaning researchers looked back at data that had already been collected. All investigations and evaluations on humans were conducted with the approval of the responsible ethics committee. The study was conducted in compliance with the ethical standards of the responsible institution on human subjects. The study was also conducted in compliance with the Helsinki Declaration. The Helsinki Declaration is an international set of ethical principles for medical research involving people.\u003c\/p\u003e\n\n\u003cp\u003eBetween 2009 and 2024, an ultrasound examination of the carotid artery was offered as part of occupational health screening in companies in various sectors in the region around Koblenz, Germany. The companies represented chemicals, glass, pharmaceuticals, administration, metal, social services, paper, printing, ceramics, information technology (IT), university, university of applied sciences, and retail.\u003c\/p\u003e\n\n\u003cp\u003eA total of 10,597 subjects (44% women) aged 20 to 65 years without signs of cardiovascular disease were examined by ultrasound of the carotid artery. The researchers measured the sum of all plaque areas (total plaque area, TPA) and the maximum plaque thickness.\u003c\/p\u003e\n\n\u003cp\u003eA portable ultrasound device from Kontron Medical, type Imagic Agile, with a 10 MHz linear scanner was used. A 10 MHz linear scanner is a type of ultrasound probe that produces high-resolution images of structures close to the skin, such as the carotid artery.\u003c\/p\u003e\n\n\u003cp\u003eAt baseline (the first examination) and at follow-up examinations, the researchers obtained each participant's history of previous cancer and cardiovascular disease. The cardiovascular diseases recorded were myocardial infarction (heart attack), stroke, coronary artery bypass grafting (CABG), and percutaneous transluminal coronary angioplasty (PTCA). CABG is a surgical procedure that reroutes blood around blocked heart arteries. PTCA is a procedure that opens narrowed heart arteries with a balloon and often a stent.\u003c\/p\u003e\n\n\u003cp\u003eFollow-up examinations were carried out on 3,813 subjects (42% women) with a low to medium risk aged 40 to 65 years. The follow-up rate was 57.8% for men and 51.1% for women.\u003c\/p\u003e\n\n\u003cp\u003eThe researchers determined the proportion of subjects who changed from a low or medium risk of plaque to a high risk. They then tested whether this change was predictable taking into account the classic risk factors. The classic risk factors examined were lipids (blood fats such as cholesterol and triglycerides), hypertension (high blood pressure), diabetes, smoking, familial risk (family history), and body mass index (BMI). BMI is a measure of weight relative to height.\u003c\/p\u003e\n\n\u003cp\u003eIn 2,397 men without cancer or cardiovascular events during follow-up, the researchers compared classic risk factors and plaque burden. The researchers compared 55 men who had a solid tumor and 188 men who had a cardiovascular event. They also examined whether patients with cancer and patients with a cardiovascular event exhibited different risk profiles. Due to the low cancer incidence in women, with only 15 cases, a statistical evaluation was not carried out for women.\u003c\/p\u003e\n\n\u003cp\u003eMyocardial infarction, stroke, CABG, and PTCA, or an angiographically proven coronary stenosis greater than 50%, were classified as cardiovascular events. \"Angiographically proven coronary stenosis greater than 50%\" means an X-ray dye study showed a heart artery narrowed by more than half.\u003c\/p\u003e\n\n\u003ch2 id=\"plaque-measurement\"\u003eHow Plaque Was Measured and Classified\u003c\/h2\u003e\n\n\u003cp\u003eThe measurement method was performed as previously published by the same research group. The classification of ultrasound findings was developed in an independent population of patients. These patients were examined one day before a planned coronary angiography. Coronary angiography is an X-ray procedure that uses dye to show the heart's arteries.\u003c\/p\u003e\n\n\u003cp\u003eThe study used the following risk categories based on ultrasound findings:\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eLow risk:\u003c\/strong\u003e ultrasound findings types I and IIa\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eMedium risk:\u003c\/strong\u003e ultrasound findings types IIb and IVa\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eHigh risk:\u003c\/strong\u003e ultrasound findings types III and IVb\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eFor the analysis, the researchers also divided the population into two groups. The two groups were low to moderate atherosclerosis (types I, IIa, IIb, and IVa findings on ultrasound) and high risk (types III and IVb).\u003c\/p\u003e\n\n\u003cp\u003eFor each age group from 20 to 65 years, the researchers created percentile curves of the plaque area (TPA) for men and women. A percentile curve shows how a person's measurement compares with others of the same age and sex. The researchers also reported the percentage of subjects with advanced atherosclerosis, meaning type III or IVb findings.\u003c\/p\u003e\n\n\u003ch2 id=\"findings-baseline\"\u003eKey Findings: Plaque Burden by Age and Sex\u003c\/h2\u003e\n\n\u003cp\u003eIn the age group of 25 to 65 years, 5,672 men and 4,652 women were examined. The researchers found that 584 men (10.3%) and 180 women (3.9%) had advanced atherosclerosis of type III or IVb.\u003c\/p\u003e\n\n\u003cp\u003eIn the age group of 35 to 65 years, 12% of men and 4.2% of women had advanced atherosclerosis (types III and IVb). This shows that advanced plaque buildup becomes substantially more common with increasing age, and that it is more common in men than in women at every age.\u003c\/p\u003e\n\n\u003cp\u003eThe baseline characteristics of all subjects were compared by risk group. The table below summarizes the key differences between men and women with low to moderate plaque (types I, IIa, IIb, IVa) and those with high-risk plaque (types III, IVb).\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen with high-risk plaque (540 men) compared with men with low to moderate plaque (2,052 men):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 54 ± 6 years versus 50 ± 7 years (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eBMI: 27.94 ± 4.20 kg\/m² versus 27.47 ± 4.08 kg\/m² (P = 0.002)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 238 (43.5%) versus 458 (22.3%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 159 ± 40 mg\/dL versus 150 ± 33 mg\/dL (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 48 ± 11 mg\/dL versus 51 ± 12 mg\/dL (P = 0.001)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 188 ± 123 mg\/dL versus 170 ± 117 mg\/dL (P = 0.001)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure (SBP): 135 ± 19 mm Hg versus 126 ± 15 mm Hg (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure (DBP): 84 ± 10 mm Hg versus 82 ± 8 mm Hg (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 47 (8.6%) versus 76 (3.7%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 206 (37.7%) versus 440 (21.4%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 159 (29.1%) versus 450 (21.9%) (P = 0.034)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 14.4 ± 11.1% versus 6.5 ± 6.5% (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 150 ± 64 mm² versus 32 ± 33 mm² (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 2.9 ± 0.8 mm versus 1.7 ± 0.5 mm (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eCardiovascular event (MACE, CABG, PTCA, stenosis): 128 (23.4%) versus 60 (2.9%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eCarcinoma: 34 (6.2%) versus 21 (1.0%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eFollow-up: 74 months (range 3-145) versus 73 months (range 3-156) (P = 0.032)\u003c\/li\u003e\n\u003cli\u003eDeath from all causes: 42 (7.7%) versus 14 (0.7%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eDeath from cardiovascular disease: 17 (3.1%) versus 5 (0.2%) (P = 0.0004)\u003c\/li\u003e\n\u003cli\u003eDeath from carcinoma: 20 (4.4%) versus 4 (0.2%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eWomen with high-risk plaque (167 women) compared with women with low to moderate plaque (1,761 women):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 55 ± 6 years versus 50 ± 7 years (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eBMI: 26.02 ± 4.72 kg\/m² versus 25.40 ± 4.68 kg\/m² (P = 0.101)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 79 (47.3%) versus 339 (19.3%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 160 ± 40 mg\/dL versus 143 ± 33 mg\/dL (P = 0.002)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 63 ± 14 mg\/dL versus 65 ± 15 mg\/dL (P = 0.116)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 143 ± 71 mg\/dL versus 112 ± 58 mg\/dL (P = 0.005)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 131 ± 19 mm Hg versus 122 ± 16 mm Hg (P = 0.0002)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 86 ± 12 mm Hg versus 78 ± 9 mm Hg (P = 0.143)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 11 (6.6%) versus 25 (1.4%) (P = 0.009)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 80 (47.9%) versus 318 (18.1%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 65 (38.9%) versus 485 (27.5%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 5.1 ± 5.4% versus 1.5 ± 2.4% (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 123 ± 63 mm² versus 16 ± 24 mm² (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 3.1 ± 0.6 mm versus 1.6 ± 0.4 mm (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eCardiovascular event: 13 (7.8%) versus 4 (0.2%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eCarcinoma: 3 (1.8%) versus 12 (0.7%) (P = 0.289)\u003c\/li\u003e\n\u003cli\u003eFollow-up: 75 months (range 2-139) versus 74 months (range 2-155) (P = 0.836)\u003c\/li\u003e\n\u003cli\u003eDeath from all causes: 0 versus 6 (0.3%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eDeath from cardiovascular disease: 0 versus 2 (0.1%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eDeath from carcinoma: 0 versus 1 (0.06%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThese baseline results show that people with high-risk plaque had consistently worse risk factor profiles. They were older, smoked more, had higher LDL cholesterol and triglycerides, higher blood pressure, more diabetes, and higher PROCAM risk scores. The PROCAM score is a widely used tool that estimates the 10-year risk of a heart attack. Their plaque burden was also dramatically higher, with TPA roughly four to eight times greater than in the low to moderate risk groups.\u003c\/p\u003e\n\n\u003ch2 id=\"findings-progression\"\u003eKey Findings: Who Developed Advanced Plaque During Follow-Up\u003c\/h2\u003e\n\n\u003cp\u003eIn the age group of 40 to 65 years, 2,592 men and 1,928 women were followed up. Low to moderate atherosclerosis was present in 2,052 men (79.2%) and 1,761 women (91.3%) at the start.\u003c\/p\u003e\n\n\u003cp\u003eDuring follow-up, 139 men (6.8%) and 39 women (2.2%) developed advanced atherosclerosis of type III or IVb. Critically, this progression could not be predicted by the classic risk factors (P \u0026gt; 0.05). The mean follow-up time was 73 months (about 6.1 years) for men and 75 months (about 6.3 years) for women.\u003c\/p\u003e\n\n\u003cp\u003eThe researchers then examined the men and women who progressed to high plaque risk in detail.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen who progressed (139 men) compared with men who did not (1,913 men):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 50 ± 5 years versus 50 ± 6 years (P = 0.5042)\u003c\/li\u003e\n\u003cli\u003eBMI: 27.80 ± 4.48 kg\/m² versus 27.47 ± 4.08 kg\/m² (P = 0.4030)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 40 (28.8%) versus 423 (22.1%) (P = 0.0954)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 153 ± 32 mg\/dL versus 150 ± 33 mg\/dL (P = 0.2661)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 52 ± 13 mg\/dL versus 51 ± 11 mg\/dL (P = 0.4186)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 174 ± 133 mg\/dL versus 169 ± 116 mg\/dL (P = 0.6990)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 130 ± 17 mm Hg versus 127 ± 16 mm Hg (P = 0.0047)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 83 ± 10 mm Hg versus 81 ± 8 mm Hg (P = 0.0763)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 9 (6.5%) versus 67 (3.5%) (P = 0.1662)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 34 (24.5%) versus 409 (21.4%) (P = 0.4240)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 27 (19.4%) versus 423 (22.1%) (P = 0.4436)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 8.1 ± 7.5% versus 6.5 ± 6.4% (P = 0.0360)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 53 ± 30 mm² versus 30 ± 33 mm² (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 1.79 ± 0.5 mm versus 1.7 ± 0.5 mm (P = 0.000017)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eWomen who progressed (39 women) compared with women who did not (1,722 women):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 51 ± 6 years versus 50 ± 6 years (P = 0.1942)\u003c\/li\u003e\n\u003cli\u003eBMI: 24.03 ± 5.92 kg\/m² versus 25.41 ± 4.80 kg\/m² (P = 0.0186)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 12 (30.8%) versus 351 (20.4%) (P = 0.1767)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 146 ± 35 mg\/dL versus 143 ± 32 mg\/dL (P = 0.6567)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 65 ± 13 mg\/dL versus 65 ± 15 mg\/dL (P = 0.9377)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 118 ± 60 mg\/dL versus 112 ± 59 mg\/dL (P = 0.5433)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 126 ± 18 mm Hg versus 121 ± 16 mm Hg (P = 0.1116)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 78 ± 9 mm Hg versus 78 ± 9 mm Hg (P = 0.9849)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 0 (0%) versus 27 (1.6%) (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 8 (20.5%) versus 308 (17.9%) (P = 0.6998)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 10 (25.6%) versus 475 (27.6%) (P = 0.7876)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 1.8 ± 2.4% versus 1.5 ± 2.5% (P = 0.5312)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 48 ± 34 mm² versus 17 ± 24 mm² (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 2.1 ± 0.5 mm versus 1.6 ± 0.4 mm (P \u0026lt; 0.0001)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThe only classic risk factor that differed significantly between men who progressed and men who did not was systolic blood pressure (P \u0026lt; 0.05). All other classic risk factors showed no statistically significant difference. In women, the only significant differences were BMI and diabetes, and the direction of the BMI difference was unexpected, with progressing women having a slightly lower BMI.\u003c\/p\u003e\n\n\u003cp\u003eThe researchers also reported the proportion of men and women with advanced atherosclerosis by age group. The table below shows the percentage of people with type III or IVb findings in each age band.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen with advanced atherosclerosis (type III, IVb) by age group:\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e25-29 years: 0.3%\u003c\/li\u003e\n\u003cli\u003e30-34 years: 0.8%\u003c\/li\u003e\n\u003cli\u003e35-39 years: 2.2%\u003c\/li\u003e\n\u003cli\u003e40-44 years: 4.5%\u003c\/li\u003e\n\u003cli\u003e45-49 years: 9.5%\u003c\/li\u003e\n\u003cli\u003e50-54 years: 12.5%\u003c\/li\u003e\n\u003cli\u003e55-59 years: 22.2%\u003c\/li\u003e\n\u003cli\u003e60-65 years: 26.8%\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eWomen with advanced atherosclerosis (type III, IVb) by age group:\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e25-29 years: 0.0%\u003c\/li\u003e\n\u003cli\u003e30-34 years: 0.0%\u003c\/li\u003e\n\u003cli\u003e35-39 years: 0.9%\u003c\/li\u003e\n\u003cli\u003e40-44 years: 0.9%\u003c\/li\u003e\n\u003cli\u003e45-49 years: 2.8%\u003c\/li\u003e\n\u003cli\u003e50-54 years: 4.1%\u003c\/li\u003e\n\u003cli\u003e55-59 years: 8.0%\u003c\/li\u003e\n\u003cli\u003e60-65 years: 9.2%\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThe researchers also tracked how many people changed from low to moderate risk to high risk during follow-up, by age group.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen who changed to type III\/IVb during follow-up:\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e40-44 years: 477 examined, 24 changed (5.0%)\u003c\/li\u003e\n\u003cli\u003e45-49 years: 584 examined, 40 changed (6.8%)\u003c\/li\u003e\n\u003cli\u003e50-54 years: 499 examined, 46 changed (9.2%)\u003c\/li\u003e\n\u003cli\u003e55-59 years: 335 examined, 26 changed (7.8%)\u003c\/li\u003e\n\u003cli\u003e60-65 years: 147 examined, 2 changed (1.4%)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eWomen who changed to type III\/IVb during follow-up:\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e40-44 years: 348 examined, 7 changed (2.0%)\u003c\/li\u003e\n\u003cli\u003e45-49 years: 486 examined, 5 changed (1.0%)\u003c\/li\u003e\n\u003cli\u003e50-54 years: 480 examined, 15 changed (3.1%)\u003c\/li\u003e\n\u003cli\u003e55-59 years: 324 examined, 10 changed (3.1%)\u003c\/li\u003e\n\u003cli\u003e60-65 years: 125 examined, 2 changed (1.6%)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThe authors noted that the expected percentage of subjects with rapid progression of disease was in good agreement with the actual percentage. For example, in the age group of 40 to 44 years, 4.5% of men had advanced atherosclerosis at baseline. In this group, 477 subjects with low to medium risk of plaque were followed up, and 24 of them (5%) developed rapid progression. The authors concluded that who is affected cannot be predicted with the classic risk factors, since all P-values were greater than 0.05 except for systolic blood pressure in men (P \u0026lt; 0.05).\u003c\/p\u003e\n\n\u003cp\u003eThe authors suggested that this is probably also the reason why the classic risk scores only work to a very limited extent.\u003c\/p\u003e\n\n\u003ch2 id=\"findings-cancer\"\u003eKey Findings: Cancer, Cardiovascular Events, and Plaque Burden\u003c\/h2\u003e\n\n\u003cp\u003ePatients with cancer and a cardiovascular event had a significantly higher risk profile and greater plaque burden than men without cancer or cardiovascular events. However, patients with cancer and patients with cardiovascular events had a very similar risk profile and plaque burden.\u003c\/p\u003e\n\n\u003cp\u003eThe following cancers occurred among the participants. Nine bronchial (lung), six colon, two bladder, three brain, four stomach, two renal (kidney), three pancreas, 17 prostate, one base of the tongue, one esophagus, four unknown, one gallbladder, one larynx, and one lymphoma.\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen with cancer (55 men) compared with men without cancer or cardiovascular disease (2,397 men):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 55 ± 5 years versus 50 ± 6 years (P = 0.00003)\u003c\/li\u003e\n\u003cli\u003eBMI: 27.18 ± 4.48 kg\/m² versus 27.48 ± 4.08 kg\/m² (P = 0.53300)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 23 (41.8%) versus 603 (25.2%) (P = 0.01738)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 151 ± 32 mg\/dL versus 151 ± 33 mg\/dL (P = 0.94355)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 52 ± 13 mg\/dL versus 50 ± 11 mg\/dL (P = 0.52725)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 198 ± 133 mg\/dL versus 172 ± 116 mg\/dL (P = 0.26128)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 135 ± 17 mm Hg versus 128 ± 16 mm Hg (P = 0.02165)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 84 ± 10 mm Hg versus 82 ± 8 mm Hg (P = 0.05588)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 2 (3.6%) versus 103 (4.3%) (P = 0.79888)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 19 (34.5%) versus 572 (23.9%) (P = 0.10744)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 13 (23.6%) versus 549 (22.9%) (P = 0.90068)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 12.8 ± 7.5% versus 7.5 ± 6.4% (P = 0.03379)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 103 ± 30 mm² versus 49 ± 33 mm² (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 2.6 ± 0.5 mm versus 2.1 ± 0.5 mm (P = 0.00037)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen with a cardiovascular event (188 men) compared with men without cancer or cardiovascular disease (2,397 men):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 54 ± 6 years versus 50 ± 6 years (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eBMI: 28.10 ± 4.08 kg\/m² versus 27.48 ± 4.08 kg\/m² (P = 0.0161)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 85 (45.2%) versus 603 (25.2%) (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 161 ± 33 mg\/dL versus 151 ± 33 mg\/dL (P = 0.00065)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 48 ± 11 mg\/dL versus 50 ± 11 mg\/dL (P = 0.00275)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 194 ± 116 mg\/dL versus 172 ± 116 mg\/dL (P = 0.01691)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 133 ± 16 mm Hg versus 128 ± 16 mm Hg (P = 0.00153)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 83 ± 8 mm Hg versus 82 ± 8 mm Hg (P = 0.12071)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 20 (10.6%) versus 103 (4.3%) (P = 0.00620)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 68 (36.2%) versus 572 (23.9%) (P = 0.00081)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 58 (30.9%) versus 549 (22.9%) (P = 0.02357)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 14.9 ± 6.4% versus 7.5 ± 6.4% (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 133 ± 33 mm² versus 49 ± 33 mm² (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 2.7 ± 0.5 mm versus 2.1 ± 0.5 mm (P \u0026lt; 0.00001)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003e\u003cstrong\u003eMen with a cardiovascular event (188 men) compared with men with cancer (55 men):\u003c\/strong\u003e\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003eAge: 54 ± 6 years versus 55 ± 5 years (P = 0.9690)\u003c\/li\u003e\n\u003cli\u003eBMI: 28.10 ± 4.08 kg\/m² versus 27.18 ± 4.48 kg\/m² (P = 0.0650)\u003c\/li\u003e\n\u003cli\u003eCurrent smoker: 85 (45.2%) versus 23 (41.8%) (P = 0.6857)\u003c\/li\u003e\n\u003cli\u003eLDL cholesterol: 161 ± 33 mg\/dL versus 151 ± 32 mg\/dL (P = 0.0677)\u003c\/li\u003e\n\u003cli\u003eHDL cholesterol: 48 ± 11 mg\/dL versus 52 ± 13 mg\/dL (P = 0.0731)\u003c\/li\u003e\n\u003cli\u003eTriglycerides: 194 ± 116 mg\/dL versus 198 ± 133 mg\/dL (P = 0.8708)\u003c\/li\u003e\n\u003cli\u003eSystolic blood pressure: 133 ± 16 mm Hg versus 135 ± 17 mm Hg (P = 0.4497)\u003c\/li\u003e\n\u003cli\u003eDiastolic blood pressure: 83 ± 8 mm Hg versus 84 ± 10 mm Hg (P = 0.4753)\u003c\/li\u003e\n\u003cli\u003eDiabetes mellitus: 20 (10.6%) versus 2 (3.6%) (P = 0.0413)\u003c\/li\u003e\n\u003cli\u003eAntihypertensive therapy: 68 (36.2%) versus 19 (34.5%) (P = 0.8620)\u003c\/li\u003e\n\u003cli\u003ePositive family history: 58 (30.9%) versus 13 (23.6%) (P = 0.3092)\u003c\/li\u003e\n\u003cli\u003ePROCAM risk score: 14.9 ± 6.4% versus 12.8 ± 7.5% (P = 0.4608)\u003c\/li\u003e\n\u003cli\u003eTotal plaque area (TPA): 133 ± 33 mm² versus 103 ± 30 mm² (P = 0.0153)\u003c\/li\u003e\n\u003cli\u003eMaximum plaque thickness: 2.7 ± 0.5 mm versus 2.6 ± 0.5 mm (P = 0.5322)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eThe comparison between men with cancer and men with cardiovascular events showed remarkably similar profiles. The two groups did not differ significantly in age, BMI, smoking, LDL cholesterol, HDL cholesterol, triglycerides, systolic blood pressure, diastolic blood pressure, antihypertensive therapy, family history, or PROCAM risk score. The only significant differences were diabetes (more common in the cardiovascular event group, 10.6% versus 3.6%, P = 0.0413) and total plaque area (higher in the cardiovascular event group, 133 ± 33 mm² versus 103 ± 30 mm², P = 0.0153).\u003c\/p\u003e\n\n\u003cp\u003eThe researchers also compared baseline characteristics for all subjects with low and intermediate risk who did and did not have follow-up. This analysis was done to check whether the followed-up group was representative of the whole group. The results showed no significant differences between those who returned for follow-up and those who did not. All P-values were above 0.05 for age, BMI, smoking, lipids, blood pressure, diabetes, and antihypertensive therapy.\u003c\/p\u003e\n\n\u003ch2 id=\"treatment\"\u003eTreatment Given to High-Risk Participants\u003c\/h2\u003e\n\n\u003cp\u003ePatients at high risk, meaning those with types III and IVb ultrasound findings, received a letter to their family doctor recommending treatment with a statin, for example atorvastatin. Statins are medications that lower cholesterol and reduce inflammation in the arteries.\u003c\/p\u003e\n\n\u003cp\u003eTwo hundred fifty-nine men (47.9%) and 98 women (58.7%) received a statin. In 15 subjects, statin use was irregular. If the duration of use was less than 50% of the follow-up period, it was considered no treatment, and vice versa. In 11 subjects, statins were not tolerated and had to be discontinued.\u003c\/p\u003e\n\n\u003cp\u003eThe statin dose remained constant between the first and second visits and was adhered to by the patients.\u003c\/p\u003e\n\n\u003ch2 id=\"hypothesis\"\u003eThe Hypothesis: Microvascular Dysfunction, Heart Disease, and Cancer\u003c\/h2\u003e\n\n\u003cp\u003eAtherosclerosis is an inflammatory disease of the arteries and remains the most common cause of death in industrialized nations. The first plaques can be found in men at the age of 24 and in women at the age of 26.\u003c\/p\u003e\n\n\u003cp\u003eThere are men and women in every age group who already have advanced atherosclerosis, which is associated with a high risk of cardiovascular disease. This proportion increases with age. This means that in every age group, there is a further proportion of people who develop rapid progression of atherosclerosis within a few years.\u003c\/p\u003e\n\n\u003cp\u003eThe authors propose that it is important to look at the disease itself and not just the classic risk factors. Advanced or rapidly progressing atherosclerosis is associated with a high risk of cardiovascular disease. This risk can be significantly reduced with early treatment with a statin. Therefore, the authors argue, it is useful to measure the plaque burden on the carotid artery with ultrasound in men and women from the age of 35 or 45. The examination should be repeated after 3 to 5 years, so that people with rapid progression of atherosclerosis are not overlooked.\u003c\/p\u003e\n\n\u003cp\u003eThe examinations are offered to employees at companies every 3 years. This means that employees are examined without selection, but unfortunately not all of them participate. Participation in the study is voluntary. Therefore, the follow-up is not complete. In some companies, the examination only took place once.\u003c\/p\u003e\n\n\u003cp\u003eIn addition, there is evidence that advanced atherosclerosis and microvascular dysfunction are not only associated with an increased risk of cardiovascular events, but also with an increased risk of cancer. Men with cancer and cardiovascular events show a very similar risk profile and a significantly increased plaque burden compared to men without events.\u003c\/p\u003e\n\n\u003cp\u003eMicrovascular dysfunction probably affects not only the prearterioles and arterioles of the coronary vessels, but also other organs. Prearterioles and arterioles are the smallest branches of the arteries, just before the capillaries.\u003c\/p\u003e\n\n\u003cp\u003eThe authors describe two types of changes that occur in microvascular dysfunction:\u003c\/p\u003e\n\n\u003cul\u003e\n\u003cli\u003e\n\u003cstrong\u003eStructural changes:\u003c\/strong\u003e obstruction (blockage) and perivascular fibrosis (scarring around the blood vessels)\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eFunctional changes:\u003c\/strong\u003e increased vascular tone caused by increased production of endothelin, prostacyclin, or peptide Y, or decreased production of nitric oxide (NO)\u003c\/li\u003e\n\u003c\/ul\u003e\n\n\u003cp\u003eNitric oxide is a molecule that helps blood vessels relax and widen. When nitric oxide production decreases, blood vessels can become stiffer and narrower.\u003c\/p\u003e\n\n\u003cp\u003eHypoxia (low oxygen levels in tissues) affects the proliferation and expression of the genes hypoxia-inducible factor-1-alpha (HIF-1α) and JMJD1A in head and neck tumor cells. Natural killer (NK) cells are the first line of defense against infections and cancer cells. Hypoxia upregulates (increases) the transcription factor HIF-1α, which slows down the activity of NK cells in tumor defense.\u003c\/p\u003e\n\n\u003cp\u003eRashid and colleagues consider HIF-1α to be an important transcription factor in cancer development. Hypoxia acts as an overarching driver and master regulator of cancer development.\u003c\/p\u003e\n\n\u003cp\u003eThe authors also reference a book by Haverich and Boyle on atherosclerosis pathogenesis and microvascular dysfunction. There is a physiological growth process of the intima (the innermost layer of the artery wall) that is part of normal development.\u003c\/p\u003e\n\n\u003ch2 id=\"implications\"\u003eWhat This Means for Patients\u003c\/h2\u003e\n\n\u003cp\u003eThis study has several important implications for patients and their doctors.\u003c\/p\u003e\n\n\u003cp\u003eFirst, measuring plaque burden in the carotid artery with ultrasound provides good risk stratification in every age group. Risk stratification means sorting people into groups based on their likelihood of developing a disease. This is important because it allows doctors to identify people who need early treatment.\u003c\/p\u003e\n\n\u003cp\u003eSecond, a follow-up examination every 3 to 5 years is advisable. The reason is that rapid progression of the disease cannot be predicted by taking into account the classic risk factors alone. This means that even if a person's cholesterol, blood pressure, and other standard risk factors look good, they may still develop advanced atherosclerosis quickly.\u003c\/p\u003e\n\n\u003cp\u003eThird, early treatment of advanced atherosclerosis improves the prognosis for cardiovascular diseases and possibly also for certain types of cancer. The study found that patients with cancer and cardiovascular events show a similar risk profile and plaque burden. This suggests that the two conditions may share underlying mechanisms.\u003c\/p\u003e\n\n\u003cp\u003eFourth, the classic risk scores only work to a very limited extent. This is probably because they do not capture the actual disease process in the arteries. The authors argue that it is therefore important to look at the disease itself and not just the classic risk factors.\u003c\/p\u003e\n\n\u003cp\u003eFifth, the finding that men with cancer have a significantly higher plaque burden than men without cancer or cardiovascular disease suggests something. Atherosclerosis may be a marker of cancer risk as well as heart risk. The authors hypothesize that microvascular dysfunction, which affects the smallest blood vessels, may be a common link between cardiovascular disease and cancer.\u003c\/p\u003e\n\n\u003ch2 id=\"limitations\"\u003eLimitations: What the Study Could Not Prove\u003c\/h2\u003e\n\n\u003cp\u003eThe study has several limitations that patients and doctors should keep in mind.\u003c\/p\u003e\n\n\u003cp\u003eFirst, this was a retrospective study, meaning it looked back at data that had already been collected. Retrospective studies can show associations but cannot prove cause and effect.\u003c\/p\u003e\n\n\u003cp\u003eSecond, participation in the study was voluntary. This means that the people who chose to participate may not be representative of the general population. People who are more health-conscious may be more likely to participate.\u003c\/p\u003e\n\n\u003cp\u003eThird, the follow-up is not complete. In some companies, the examination only took place once. The follow-up rate was 57.8% for men and 51.1% for women. This means that many people who were examined at baseline did not return for follow-up.\u003c\/p\u003e\n\n\u003cp\u003eFourth, due to the low cancer incidence in women, with only 15 cases, a statistical evaluation was not carried out for women. This means the cancer findings apply primarily to men.\u003c\/p\u003e\n\n\u003cp\u003eFifth, the number of men with cancer was relatively small (55 men). This limits the statistical power of the cancer analyses.\u003c\/p\u003e\n\n\u003cp\u003eSixth, the study population was drawn from companies in a specific region of Germany. The findings may not apply to other populations or regions.\u003c\/p\u003e\n\n\u003cp\u003eSeventh, the hypothesis about the relationship between microvascular dysfunction, cardiovascular disease, and cancer is just that, a hypothesis. It needs to be tested in further studies.\u003c\/p\u003e\n\n\u003ch2 id=\"recommendations\"\u003eRecommendations\u003c\/h2\u003e\n\n\u003cp\u003eBased on the findings of this study, the authors make the following recommendations:\u003c\/p\u003e\n\n\u003col\u003e\n\u003cli\u003e\n\u003cstrong\u003eConsider carotid ultrasound screening.\u003c\/strong\u003e Men and women from the age of 35 or 45 should consider having their plaque burden measured with ultrasound of the carotid artery. This examination can detect advanced atherosclerosis before symptoms appear.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eRepeat the examination every 3 to 5 years.\u003c\/strong\u003e Because rapid progression of atherosclerosis cannot be predicted from classic risk factors, repeat examinations are important to catch people who are progressing quickly.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eDo not rely on classic risk factors alone.\u003c\/strong\u003e Even if your cholesterol, blood pressure, and other standard risk factors are normal, you may still have advanced atherosclerosis. Measuring plaque burden directly provides additional information.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eSeek early treatment if advanced atherosclerosis is found.\u003c\/strong\u003e Early treatment with a statin, such as atorvastatin, can significantly reduce the risk of cardiovascular disease. In this study, 47.9% of high-risk men and 58.7% of high-risk women received a statin.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eBe aware of the possible link between atherosclerosis and cancer.\u003c\/strong\u003e The study found that men with cancer have a significantly higher plaque burden than men without cancer or cardiovascular disease.\u003c\/li\u003e\n\u003cli\u003e\n\u003cstrong\u003eParticipate in workplace health screenings.\u003c\/strong\u003e The study offered ultrasound examinations as part of occupational health screening. Taking advantage of these opportunities can help detect disease early.\u003c\/li\u003e\n\u003c\/ol\u003e\n\n\u003c!-- ddn:faq:start --\u003e\n\u003ch2 id=\"ddn-faq\"\u003eFrequently Asked Questions\u003c\/h2\u003e\n\u003ch3\u003eWhat did the neck artery ultrasound study find about predicting plaque buildup?\u003c\/h3\u003e\n\u003cp\u003eIn a study of 10,597 adults aged 20 to 65 without heart disease symptoms, advanced atherosclerosis could not be predicted from classic risk factors such as cholesterol, blood pressure, diabetes, smoking, family history, and body mass index. In the 40-65 age group, 6.8% of men and 2.2% of women developed advanced plaque over about six years, and these changes were not explained by those risk factors.\u003c\/p\u003e\n\u003ch3\u003eWho might consider a carotid ultrasound screening, and how often should it be repeated?\u003c\/h3\u003e\n\u003cp\u003eThe authors recommend that men and women from age 35 or 45 consider having their plaque burden measured with ultrasound of the carotid artery. Because rapid progression cannot be predicted from classic risk factors alone, they advise repeating the examination every 3 to 5 years. This can detect advanced atherosclerosis before symptoms appear and help identify people who need early treatment.\u003c\/p\u003e\n\u003ch3\u003eWhat are the limitations of this study that I should know about?\u003c\/h3\u003e\n\u003cp\u003eThis was a retrospective study, so it can show associations but cannot prove cause and effect. Participation was voluntary, and the follow-up rate was 57.8% for men and 51.1% for women, meaning many did not return. The number of men with cancer was small (55 men), and due to only 15 cancer cases in women, statistical evaluation was not done for women. The findings may not apply to other populations.\u003c\/p\u003e\n\u003ch3\u003eWhen should a patient with high-risk carotid plaque on ultrasound seek a second opinion?\u003c\/h3\u003e\n\u003cp\u003eA second opinion is worth considering when carotid ultrasound shows high-risk plaque (types III or IVb) or rapid progression, because classic risk factors such as cholesterol, blood pressure, diabetes, smoking, family history, and body mass index did not predict who developed advanced plaque. A review can confirm the plaque measurement and help weigh early statin treatment, which improves cardiovascular prognosis and possibly certain cancers. Repeat ultrasound every 3 to 5 years is advisable. Diagnostic Detectives Network provides independent expert second opinions.\u003c\/p\u003e\n\u003c!-- ddn:faq:end --\u003e\n\n\u003ch2 id=\"source\"\u003eSource Information\u003c\/h2\u003e\n\n\u003cp\u003e\u003cstrong\u003eOriginal article title:\u003c\/strong\u003e Articles © The authors | Journal compilation © Cardiol Res and Elmer Press Inc™ | https:\/\/cr.elmerpub.com\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthors:\u003c\/strong\u003e Ansgar Adams, Waldemar Bojara, Michel Romanens\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eAuthor affiliations:\u003c\/strong\u003e B·A·D Health Care and Safety Technology Centre GmbH, Koblenz, Germany; Community Clinic Mittelrhein, Kemperhof II, The Cardiology Clinic, Koblenz, Germany; Vascular Risk Foundation (Varifo), Olten, Switzerland\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eCorresponding author:\u003c\/strong\u003e Ansgar Adams, B·A·D Gesundheitsvorsorge und Sicherheitstechnik GmbH Zentrum Koblenz, Bubenheimer Bann 4, 56070 Koblenz, Germany. Email: ansgar.adams@bad-gmbh.de\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eJournal:\u003c\/strong\u003e Cardiology Research (Cardiol Res), 2025\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eDOI:\u003c\/strong\u003e https:\/\/doi.org\/10.14740\/cr2049\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003ePublication history:\u003c\/strong\u003e Manuscript submitted January 17, 2025; accepted March 31, 2025; published online April 11, 2025\u003c\/p\u003e\n\n\u003cp\u003e\u003cstrong\u003eKeywords:\u003c\/strong\u003e Microvascular dysfunction; Atherosclerosis; Cardiovascular risk; Cancer; Carotid ultrasound\u003c\/p\u003e\n\n\u003cp\u003e\u003cem\u003eThis patient-friendly article is based on peer-reviewed research. It is intended for educational purposes and should not replace consultation with a qualified healthcare professional. Patients should discuss any questions about their cardiovascular risk, cancer risk, or treatment options with their doctor.\u003c\/em\u003e\u003c\/p\u003e","brand":"DiagnosticDetectives.Com","offers":[{"title":"Default Title","offer_id":47807307055260,"sku":null,"price":0.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/0599\/5449\/5644\/files\/ddn-medical-article-neck-artery-ultrasound-predicts-heart-risk-and-may-be-linked-to-cancer-a-15-year-study-of-10-597-adults-hero.png?v=1792732936","url":"https:\/\/diagnosticdetectives.com\/he\/products\/neck-artery-ultrasound-predicts-heart-risk-and-may-be-linked-to-cancer-a-15-year-study-of-10-597-adults","provider":"DiagnosticDetectives.Com","version":"1.0","type":"link"}