2002 年 15 巻 3 号 p. 120-127
The main aims of public health care are the prevention of cardiovascular disease and management of malignant disease. For the prevention of cardiovascular disease, risk factor control such as treatment of hypertension, hyperlipidemia, diabetes mellitus, and cessation of tobacco smoking are important. In Japan, financial support for extra health care checks aimed at the prevention of cardiovascular disease was started in April 2001. Carotid and cardiac ultrasonography were nominated as second-line examinations in patients with high blood pressure, high blood lipid levels, high blood sugar, and obesity.
Carotid atherosclerosis is known to be a useful indicator of ischemic cerebrovascular disease and ischemic heart disease. Noninvasive ultrasonic examination is a standard method for assessment of carotid artery disease. In this paper, I explain the present consensus for evaluating carotid atherosclerosis by ultrasonography in line with the Japanese guidelines. If a patient is found to have obvious carotid atherosclerosis, it is necessary to conduct more intensive control of the risk factors. More severe control is needed for reduction of blood pressure and cholesterol, recovery of insulin resistance, and so on.