Russian Cardiology Research and Production Complex of Russian Ministry of Health, Moscow, Russian Federation
*Corresponding author: Saule J. Urazalina, PhD, Russian Cardiology Research and Production Complex of Russian Ministry of Health, 15a, 3rd Cherepkovskaya str.,121552, Moscow, Russian Federation. Tel: 7-985-2642849, E-Mail: email@example.com
Objective: To identify individuals at high cardiovascular risk (CVR) to check for an additional estimate of CVR with the use of the ESH/ESC Guidelines (2003, 2007) in patients earlier classified as being at low and moderate risk on «SCORE». Material and methods: The study included 600 people (155 men and 445 women) with low and moderate cardiovascular risk on the SCORE scale. All patients were examined with duplex scanning of the carotid arteries (DSCA) to the determined of the thickness of the intima-media (IMT), the presence of atherosclerotic plaques (ASP); it has also been performed sphygmographic computer (SC) with automatic estimation of brachial-ankle pulse wave velocity (baPWV), biochemical analysis of blood lipid spectrum. Results: The frequency of ASP was 59.5% (357 out of 600), and a thickening of the complex "intima-media" (IMT)>0.9 mm was detected in only 5% of the cases (28 persons out of 600), that indicated a slight contribution to the magnitude of the risk of such parameters as the IMT. The total number of patients with signs of preclinical lesions of the arterial wall (the presence of ASP and/or increased baPWV) was 337 (56% of 600). Our results showed that the presence of subclinical atherosclerosis is in itself a risk factor. Conclusion: The usage of instrumental methods of research (DSCA, SC) allowed to detect 32% of individuals with high CVR from 600 previously classified as low and moderate risk on SCORE scale. In our opinion, the proposed algorithm is convenient and easy to use for transfer of the patients into high-risk group.
1. Conroy RM, Pyorala K, Fitzgerald AP et al. Estimation of ten-year risk of fatal cardiovascular disease in Europe: the SCORE project. Eur Heart J 2003; 24:987-1003.
2. ESH-ESC Guidelines committee 2007 guidelines for the management of arterial hypertension. Hypertension 2007; 25:1105-87.
3. Stein JI, Korcarz CE, et al. American Society of Echocardiography Carotid Intima-Media Thickness Task Force. J Amer Soc Echocardiography 2008; 21:93-111.
4. Belcaro G, Nicolaides AN, Ramaswami G, et al. Carotid and femoral ultrasound morphology screening and cardiovascular events in low risk subjects: a 10-year follow-up study (the CAFES-CAVE study (1)). Atherosclerosis 2001; 156(2):379-87.
5. Cournot M, Taraszkiewicz D, Cambou J, et al. Additional prognostic value of physical examination, exercise testing, and arterial ultrasonography for coronary risk assessment in primary prevention. AHJ 2009; 158(5):845-851.
6. Wang Ji-G, Staessen JA. Li Y, et al. Carotid Intima-Media Thickness and Antihypertensive Treatment. A Meta-Analysis of Randomized Controlled Trials. Stroke 2006 Jul; 37(7):1933-40.
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Int J Biomed. 2012; 2(2):102-107. © 2012 International Medical Research and Development Corporation. All rights reserved.