Objective   To examine the relationship between carotid artery abnormality and smoking in male adult residents at high-risk of cardiovascular disease (CVD) in Jiangsu province, and to provide evidences for prevention and treatment of subclinical atherosclerosis and early CVD.

  Methods   From September 2015 to June 2016, we conducted screenings on individuals at high-risk of CVD among 35 – 75-year-old permanent residents (n = 71 511) in 31 urban communities and rural villages and towns selected with cluster sampling in 6 cities of Jiangsu province; then a questionnaire survey, physical examination, laboratory test and carotid artery ultrasound examination were carried out in 4 821 male residents at high-risk of CVD to analyze the relationship between carotid artery abnormality and smoking.

  Results   Among the 4 821 high-risk individuals, 2 783 (57.73%) were diagnosed with carotid artery abnormality; of which, 761 (27.34%), 1 791 (64.57%), and 225 (8.09%) were carotid intima thickening, carotid plaque, and carotid stenosis, respectively. After adjusting confounding factors such as age, education, marriage, average annual family income, residence, and history of alcohol drinking/hypertension/diabetes/dyslipidemia, the results of unconditional multivariate logistic regression analysis demonstrated that for all the high-risk individuals, the smokers were more likely to have carotid artery abnormality (compared to non-smokers: odds ratio OR = 1.391, 95% confidence interval 95% CI = 1.214 – 1.593); the results also revealed two significant risk factors of carotid artery abnormality for the 2 699 high-risk individuals being current or former smokers: smoking filter-tipped cigarettes (compared to smoking cigarettes without filter: OR = 1.440, 95% CI = 1.184 – 1.750) and breathing in cigarette smoke deeply (breathing the smoke into throat vs. into mouth: OR = 1.420, 95% CI = 1.081 – 1.865 and breathing the smoke into lung vs. into mouth: OR = 1.338, 95% CI = 1.104 – 1.622).

  Conclusion   The prevalence rate of carotid artery abnormality is relatively high and the abnormality is strongly associated with smoking among male adult residents at high-risk of cardiovascular disease in Jiangsu province.