[8][9][10][11][12] Clinically significant CAD can be defined according to the degree of stenosis, arterial wall thickening, atheroma plaque load or dimensions, which depends on the method used to document the CAD (carotid ultrasound, tomography, magnetic resonance, autopsy, among others). 2,4,12In the general population, clinically significant CAD is more common due to plaque Abstract Introduction: Atherosclerotic carotid artery disease (CAD) is a major risk factor for cerebrovascular disease.Objective: To analyze the association of major vascular risk factors with atherosclerotic CAD and white matter disease (WMD) in patients without a history of ischemic stroke.Method: Risk factors were assessed with carotid examination using Doppler duplex ultrasound.Cases with a history cerebral infarction or transient ischemic attack were not included.Subjects had brain magnetic resonance imaging scans available and those with large-artery ischemic lesions were excluded.Multivariate models were constructed for the prediction of atherosclerotic CAD, significant carotid stenosis, atheroma burden and WMD.Results: One-hundred and forty-five subjects were assessed (60.7% were females, mean age was 73 years).Atherosclerotic CAD was documented in 54.5%, carotid stenosis ≥ 50% in 9.0%, > 6 atheroma plaques in 7.6%, and periventricular or sub-cortical WMD in 28.3% (20.6% had atherosclerotic CAD and WMD concurrently).Risk factors independently associated with atherosclerotic CAD were age and hypertension; hypertension was associated with ≥ 50% carotid stenosis; age was associated with > 6 atheroma plaques; and age, diabetes and hypertension were associated with WMD.Obesity was not associated with any of the analyzed independent variables.Conclusions: In asymptomatic subjects without a history of ischemic stroke, age and hypertension were the most important risk factors for macrovascular disease.Diabetes mellitus was associated with microvascular disease.Obesity alone was not a major determinant of CAD or WMD.