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Gender, subclinical organ damage and cardiovascular risk stratification in hypertensive patients
Lucyna Woźnicka-Leśkiewicz1, Anna Posadzy-Małaczyńska1, Justyna Marcinkowska2
1a Department of Family Medicine, Poznan University of Medical Sciences , Poznan , Poland.
Insights
Assessing subclinical organ damage using ankle-brachial index (ABI), intima-media thickness (IMT), and pulse wave velocity (PWV) significantly improves cardiovascular risk prediction, especially for women.
Area of Science:
- Cardiovascular Medicine
- Hypertension Research
- Diagnostic Imaging and Biomarkers
Background:
- Hypertension is a major risk factor for cardiovascular disease, often associated with subclinical organ damage.
- Accurate cardiovascular risk stratification is crucial for effective disease prevention and management.
- Traditional risk scores may not fully capture the impact of subclinical organ damage.
Purpose of the Study:
- To evaluate subclinical organ damage in hypertensive men and women and its impact on cardiovascular risk.
- To explore the utility of novel statistical methods for precise cardiovascular risk estimation.
- To assess the role of ankle-brachial index (ABI), intima-media thickness (IMT), and pulse wave velocity (PWV) in risk stratification.
Main Methods:
- A study involving 200 patients (100 hypertensive, 100 normotensive) was conducted.
- Evaluated parameters included age, ABI, IMT, PWV, serum uric acid, and C-reactive protein (CRP).
- Cardiovascular risk was assessed using the SCORE and Framingham scales, with logistic regression models employed.
Main Results:
- Significant correlations between vascular markers (ABI, IMT, PWV) and cardiovascular risk scores were observed in various patient groups.
- Logistic regression models incorporating ABI, IMT, and PWV demonstrated high accuracy in classifying patients into high-risk categories (up to 98% for Framingham scale).
- Classification accuracy was particularly high for women using the SCORE scale (88%).
Conclusions:
- Integrating subclinical organ damage assessments (ABI, IMT, PWV) significantly enhances cardiovascular disease prevention strategies.
- Follow-up using these vascular markers improves the accuracy of identifying individuals at high cardiovascular risk, especially women.
- The findings have significant therapeutic implications for personalized cardiovascular disease management.
Background:
The aims of the study were to assess subclinical organ damage in men and women with hypertension and its subsequent effect on cardiovascular risk, and use of new statistical methods for more precise estimation of cardiovascular risk using vascular cardiovascular risk factors: ankle-brachial index (ABI), intima-media thickness (IMT) and pulse wave velocity (PWV).
Methods:
We studied 200 patients: 100 hypertensive and 100 normotensive. The parameters we evaluated included: patient age, ABI, IMT, PWV, serum uric acid and serum C-reactive protein (CRP). In addition, the cardiovascular risk according to the SCORE and Framingham scales was assessed.
Results:
In the hypertensive group, there were significant correlations between ABI and the Framingham scale in both sexes. In hypertensive women, there were also significant correlations between IMT and the SCORE scale risk, and IMT and the Framingham scale risk. In normotensive women, there were significant correlations between ABI and the SCORE scale risk, and between ABI and the Framingham scale risk. In normotensive men, there were significant correlations between PWV and the SCORE scale risk, and between PWV and the Framingham scale risk. Lastly, in the group of normotensive men, there were significant correlations between IMT and the SCORE scale risk, and IMT and the Framingham scale risk. The possibility of correctly classifying a patient into the high-risk category by a logistic regression model using synchronous ABI, IMT and PWV was high - 74% for the risk according to the SCORE scale (66% in men, 88% in women), and 98% for the Framingham scale.
Conclusions:
The addition of recognized subclinical target organ damage tests to the estimation of cardiovascular risk can significantly strengthen the prevention of cardiovascular disease. Cardiovascular risk estimation follow-up with ABI, PWV and IMT increased the probability of correctly classifying people, especially women, into an at least high-risk category according to the SCORE scale, which has valuable therapeutic implications.
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