Tsivgoulis G et al. (2006) Common carotid arterial stiffness and the risk of ischaemic stroke. Eur J Neurol 13: 475–481

Increased common carotid artery (CCA) stiffness is an independent predictor of cardiovascular mortality in end-stage renal disease, but little is known about its relationship with cerebrovascular disease. Tsivgoulis et al. have therefore investigated the relationship between CCA stiffness—determined by high-resolution B-mode ultrasonography—and ischemic stroke.

The study included 193 patients who were admitted to an acute stroke unit in Greece with a first-ever ischemic stroke, and 106 age-matched and sex-matched controls (who had been referred to the hypertension center of the same institution).

CCA distensibility was significantly lower (i.e. stiffness was greater) in stroke patients than in control subjects (P = 0.005); this finding remained true after adjustment for known stroke risk factors such as blood pressure, height and diastolic CCA diameter (P =0.007). CCA intima–media thickness (IMT) values were significantly higher in patients with ischemic stroke than in control patients (P <0.001). In multivariate analyses, CCA-IMT and CCA distensibility were the only statistically significant predictors of ischemic stroke: each 1 SD increase in CCA-IMT increased the risk of stroke by 167.0%, and each 1 SD decrease in CCA distensibility increased the risk of stroke by 59.0%.

The authors conclude that increased CCA stiffness is associated with ischemic stroke, even after adjustment for established stroke risk factors and CCA-IMT, a marker of generalized atherosclerosis. Noninvasive measurements of CCA stiffness might, therefore, be useful for predicting stroke risk independently of the extent of atherosclerosis, but further studies are needed.