Asymptomatic carotid stenosis and stroke risk

I read with interest the Article by Dominic Howard and colleagues showing that risk of ipsilateral stroke increases with severity of asymptomatic carotid stenosis within the 50–99% range in medically treated patients.1 I understand that this Article is the first to note a significant correlation. Previously, Nicolaides and colleagues—in still the largest study of medical intervention alone (ie, lifestyle coaching and medication)—reported a trend for a correlation in patients with 50–99% asymptomatic carotid stenosis (by use of the NASCET criteria).