During the study, 186 patients were evaluated using multidetector row CT to see if CAWT is associated with cardiovascular risk factors such as hypertension, diabetes mellitus, dyslipidemia and a history of smoking. Results showed that there is a statistically significant relationship between diabetes and hypertension. "There was no significant statistical correlation between the increase of carotid wall thickness, smoking and dyslipidemia," said Luca Saba, MD, lead author of the study.

"Our group demonstrated that the presence of CAWT greater than 1mm in patients with diabetes or hypertension is strongly correlated with a risk to suffer a stroke. Patients at higher risk should be monitored every 12 months," said Dr. Saba.

"The detection and evaluation of CAWT together with the study of other cardiovascular factors allows for improvement in patient follow up and risk stratification. Imaging as part of the diagnostic process and management of patients with high cardiovascular risks is important," he said.

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"As the nation turns its attention to health care reform, we now know that much can be done to reduce racial and ethnic health care disparities and to improve the health care for all Americans," said Macinko. "We also have a lot to learn from other health care systems that measure performance based on preventable deaths."

To analyze the death disparity among African Americans and Caucasians, the scholar used "avoidable mortality," a commonly used measure of health system performance in Europe. It is defined as premature death under age 65 from conditions responsive to medical care, changes in public policy, or behaviors. Over the last decade, avoidable mortality has declined less rapidly in the United States than in other industrialized nations.

"Avoidable mortality gives us one way to assess the shortcomings of our health care system, particularly in the area of prevention," said Irma T. Elo, Ph.D., co-author on the report and an associate professor of sociology at the University of Pennsylvania. "It can help to identify where preventable disparities are greatest and aid in directing resources to where they can improve the health of vulnerable populations."

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