Document Detail

Pulse wave velocity and cardiovascular risk stratification in a general population: the Vobarno study.
MedLine Citation:
PMID:  20520574     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hypertension guidelines underline the importance of quantification of total cardiovascular risk; an extensive evaluation of target organ damage (TOD) may increase the number of patients classified at high-added cardiovascular risk.
OBJECTIVE: To assess the effect of the evaluation of different forms of TOD, in addition to 'routine' workup, on cardiovascular risk stratification in a general population sample in Northern Italy.
METHODS: In 385 patients (age 57 +/- 10 years, 44% men, 64% hypertensives, 32% treated), left ventricular and carotid artery structure and carotid-femoral pulse wave velocity (PWV) were measured. All patients underwent laboratory examinations. Patients were divided into risk categories according to European Society of Hypertension/European Society of Cardiology guidelines before and after TOD evaluation.
RESULTS: After routine workup, patients were classified as follows: 6% at average cardiovascular risk, 35% at low cardiovascular risk, 25% at moderate cardiovascular risk, 33% at high cardiovascular risk and 1% at very high cardiovascular risk. The proportion of patients at low or moderate cardiovascular risk reclassified at high cardiovascular risk were 5, 14, 30 and 14% after echocardiography, measurement of albuminuria and estimated glomerular filtration rate, carotid ultrasound and PWV, respectively (chi P < 0.001 for all vs. routine). Assessment of PWV in addition to echocardiography led to an increase of the proportion of patients at high risk (from 5 to 15%, P < 0.001), as for PWV in addition to albuminuria, estimated glomerular filtration rate or both (from 14 to 31%, P < 0.01), but did not affect risk stratification in addition to carotid ultrasound (from 30 to 34%, P = NS).
CONCLUSION: Our data suggest that measurement of PWV may significantly change cardiovascular risk stratification in addition to echocardiography and to detection of albuminuria and/or of a reduction of estimated glomerular filtration rate, but not after carotid ultrasound. Our results confirm that evaluation of different forms of TOD is useful for a more accurate assessment of global cardiovascular risk.
M Lorenza Muiesan; Massimo Salvetti; Anna Paini; Cristina Monteduro; Claudia Agabiti Rosei; Carlo Aggiusti; Eugenia Belotti; Fabio Bertacchini; Gloria Galbassini; Deborah Stassaldi; Maurizio Castellano; Enrico Agabiti Rosei
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of hypertension     Volume:  28     ISSN:  1473-5598     ISO Abbreviation:  J. Hypertens.     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-08-11     Completed Date:  2010-12-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8306882     Medline TA:  J Hypertens     Country:  England    
Other Details:
Languages:  eng     Pagination:  1935-43     Citation Subset:  IM    
Department of Medical and Surgical Sciences, Clinica Medica, University of Brescia, Brescia, Italy.
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MeSH Terms
Blood Pressure
Cardiovascular Diseases / etiology*,  physiopathology*,  ultrasonography
Carotid Arteries / ultrasonography
Hypertension / physiopathology
Middle Aged
Pulsatile Flow
Risk Factors

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