Objective  To systematically evaluate the risk factors for carotid ath-erosclerosis (CAS) in high-risk populations of stroke, providing evidence for the prevention and control of CAS.

Methods  The literature related to the risk factors of CAS in high-risk populations of stroke were retrieved from CNKI, WanFang Data, CBM, VIP, PubMed, Embase, Web of Science and the Cochrane Library. The search period was from the establishment of the database to July 11, 2025. Two researchers independently carried out literature screening, data extraction and quality evaluation. Meta-analysis was conducted using RevMan 5.4 and Stata 16.0 software.

Results  A total of 26 articles were included, involving 133 683 research subjects, and 18 risk factors were extracted. The results of the Meta-analysis showed that age (OR=1.10, 95%CI: 1.08-1.12, P<0.001), hypertension (OR=1.47, 95%CI: 1.35-1.60, P<0.001), diabetes (OR=1.47, 95%CI: 1.37-1.58, P<0.001), heart disease (OR=1.79, 95%CI: 1.25-2.56, P=0.001), history of stroke (OR=1.73, 95%CI: 1.59-1.89, P<0.001), smoking (OR=1.54, 95%CI: 1.34-1.77, P<0.001), glycated hemoglobin (OR=1.43, 95%CI: 1.09-1.87, P=0.01), low-density lipoprotein cholesterol (OR=1.45, 95%CI: 1.21-1.73, P<0.001) and high-density lipoprotein cholesterol (OR=1.37, 95%CI: 1.30-1.45, P<0.001) were risk factors for CAS in high-risk populations of stroke.

Conclusion  CAS in high-risk populations of stroke was caused by multiple factors. Healthcare professionals should enhance the identification of these CAS risk factors among high-risk populations of stroke and implement targeted intervention measures to effectively prevent and treat CAS.

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