Purpose: Atherosclerosis has become a global disease and risk factor mitigation has been a priority in counties like the Netherlands.We assessed the impact of this new approach on cardiovascular subclinical atherosclerosis and cardiovascular risk factors.

Methods: A quantitative standardized sonographic carotid intima media thickness and plaque formation(IMTplus®). IMT plus® distribution was done in accordance with the previously published protocol. (A, being a value lower than the P50, <0.700 mm; B, being a value between P50 and P90, 0,700 and 0,850 mm; C, being a value between P90 and P125, 0,851–0,948 mm ;D, being P125 and P200 with values between 0,948 −1,300 mm and an E, value above P200 >1,300 mm; P means percentile). (Prevention Concepts® Database)

Results: Distribution of IMT Plus® categories in the Netherlands and VS

The Netherlands (mean age 53 years, 60 % men) Total number of cases per category:

Total:N=18.703(100%);A:N=2685(14,4%);B:N=6425(34.4%);C:N=6600(35.3%);D:N=2372(12,7%);E:N=571(3.0%).

US (mean age 50 years 49% men) Total number of cases per category: Total:N=29.894 (100%);A:N=6001(15%);B:N=10403(26%);C:N=13199(34%);D:N=7888(19%);E:N=2403 (3%).

Conclusions: The benchmark of ten years of IMT Plus® results in the Netherlands with the US shows a different picture category A (normal risk), but a greater number of category B (25% increased risk) and a smaller amount of category D (100% increased risk) and category E (200% increased risk) in the Netherlands. The US still leads in the extent and severity of Subclinical Carotid Atherosclerosis but the Netherlands is rapidly catching up. Carotid IMTplus® remains a reliable surrogate to assess atherosclerosis development.