Document Detail


Change in cardiovascular risk profile by echocardiography in medium-risk elderly hypertensives.
MedLine Citation:
PMID:  12574787     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
It has been clearly demonstrated that ageing and arterial hypertension are both associated with an increased prevalence of left ventricular hypertrophy (LVH), which is a powerful risk factor for cardiovascular (CV) events. The objective of this study was to assess the impact of echocardiographic LVH in profiling the absolute CV risk stratification according to the 1999 World Health Organization-International Society of Hypertension (WHO/ISH) guidelines in elderly hypertensive patients. A total of 223 never-treated elderly patients (> or =65 years) with essential hypertension (98 men, 125 women, mean age 72+/-5 years) referred to our outpatient hospital clinic were included in the study. They underwent the following procedures: (1) medical history, physical examination, and clinic blood pressure; (2) routine blood chemistry and urine analysis and (3) electrocardiogram. The risk was initially stratified according to the routine procedures suggested by WHO/ISH guidelines and subsequently reassessed by adding the results of echocardiography (LVH as left ventricular mass index >51 g/m(2.7) in men and >47g/m(2.7) in women). According to routine classification, 56% (n=125) were medium-risk patients, 29% (64) high-risk and 15% (34) very-high-risk patients. The overall prevalence of LVH was 56% (48% in medium-risk and 62% in high-risk or very-high-risk patients, P<0.01). A marked change in risk stratification was observed when echocardiographic LVH was taken into consideration: medium-risk patients decreased to 29% and high-risk patients rose to 56% (P<0.01). In conclusion, ultrasound assessment of cardiac target organ damage is extremely useful in obtaining a more valid assessment of global cardiovascular risk in elderly hypertensives, because stratification based on diagnostic routine procedures can underestimate the overall risk in a large fraction (48%) of medium-risk subjects.
Authors:
C Cuspidi; L Michev; B Severgnini; S Meani; V Fusi; C Valerio; G Bertazzoli; F Magrini; A Zanchetti
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Publication Detail:
Type:  Evaluation Studies; Journal Article    
Journal Detail:
Title:  Journal of human hypertension     Volume:  17     ISSN:  0950-9240     ISO Abbreviation:  J Hum Hypertens     Publication Date:  2003 Feb 
Date Detail:
Created Date:  2003-02-07     Completed Date:  2003-05-23     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8811625     Medline TA:  J Hum Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  101-6     Citation Subset:  IM    
Affiliation:
Istituto di Clinica e Terapia Medica, Centro di Fisologia Clinica e Ipertensione, Università di Milano, Ospedale Maggiore IRCCS, Via F. Sforza 35, 20122 Milan, Italy. dhipertensione@libero.it
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Aged, 80 and over
Aging / physiology
Cardiovascular Diseases / etiology*,  physiopathology,  ultrasonography*
Echocardiography*
Female
Humans
Hypertension / complications*,  physiopathology,  ultrasonography*
Hypertrophy, Left Ventricular / complications*,  physiopathology,  ultrasonography*
Male
Reproducibility of Results
Risk Assessment*
Severity of Illness Index
Sex Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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