| Pulse wave velocity and cardiovascular risk stratification in a general population: the Vobarno study. | |
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MedLine Citation:
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PMID: 20520574 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article |
Journal Detail:
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Title: Journal of hypertension Volume: 28 ISSN: 1473-5598 ISO Abbreviation: J. Hypertens. Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-08-11 Completed Date: 2010-12-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8306882 Medline TA: J Hypertens Country: England |
Other Details:
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Languages: eng Pagination: 1935-43 Citation Subset: IM |
Affiliation:
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Department of Medical and Surgical Sciences, Clinica Medica, University of Brescia, Brescia, Italy. muiesan@med.unibs.it |
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Blood Pressure Cardiovascular Diseases / etiology*, physiopathology*, ultrasonography Carotid Arteries / ultrasonography Echocardiography Female Humans Hypertension / physiopathology Italy Male Middle Aged Pulsatile Flow Pulse* Risk Factors |
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