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[Evaluation of the individual absolute cardiovascular risk. A mathematical equation and/or arterial measurement?]
J Blacher1, L Bortolotto, P Iaria
1Service de médecine interne-thérapeutique, INSERM U 337, hôpital Broussais, Paris.
Insights
Assessing cardiovascular risk factors needs to consider the whole patient profile. Simple arterial rigidity measurements may better predict individual cardiovascular events than traditional risk equations.
Area of Science:
- Cardiology
- Vascular Biology
- Preventive Medicine
Background:
- Current cardiovascular risk assessment relies on factors like the Framingham equation.
- The Framingham equation has limitations in geographical validity and individual application.
- Arterial structure and function parameters may offer a more integrated risk assessment.
Purpose of the Study:
- To evaluate simple arterial measurements as predictors of cardiovascular risk.
- To explore alternatives to traditional risk equations for individual patient assessment.
Main Methods:
- Review of medical literature on arterial rigidity and cardiovascular risk.
- Analysis of the integration of deleterious effects of vascular risk factors over time.
Main Results:
- Arterial rigidity measurements may integrate long-term effects of multiple risk factors.
- These measurements could offer superior prediction of cardiovascular events compared to mathematical equations.
- Simple, non-invasive tests can identify high-risk individuals.
Conclusions:
- Arterial rigidity is a promising marker for individual cardiovascular risk assessment.
- Non-invasive arterial measurements can guide preventive strategies for cardiovascular risk factors.
Abstract:
The latest recommendations about the management of cardiovascular risk factors take into account not only the level of risk factor but also the global risk profile of the patient. The reference for the calculated estimation of absolute cardiovascular risk remains the Framingham equation. Nevertheless, this estimation has a number of operational and conceptual limitations such as geographical and historical validity and its application to individual cases. Different results in the medical literature suggest that parameters of arterial structure or function measured simply, such as arterial rigidity, could be closely related to the level of individual cardiovascular risk by the integration of the deleterious effects of different vascular risk factors over decades of exposition. They could then be better predict cardiovascular effects than the result of a mathematical equation which only integrates some of the risk factors at a given point in time. These simple, rapid and non-invasive measurements could help identify subjects at high cardiovascular risk and also help the clinician in the orientation of preventive measures in subjects with cardiovascular risk factors.