a Department of Family Medicine, Poznan University of Medical Sciences , Poznan , Poland.
b Department of Computer Science and Statistics, Poznan University of Medical Sciences , Poznan , Poland.
Curr Med Res Opin. 2019 Feb;35(2):367-374. doi: 10.1080/03007995.2018.1527304. Epub 2018 Oct 30.
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).
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.
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.
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.
本研究旨在评估高血压患者亚临床器官损害及其对心血管风险的后续影响，并使用新的统计方法更精确地评估血管心血管危险因素：踝臂指数（ABI）、内膜中层厚度（IMT）和脉搏波速度（PWV）的心血管风险。
我们研究了 200 名患者：100 名高血压患者和 100 名血压正常者。我们评估的参数包括：患者年龄、ABI、IMT、PWV、血尿酸和血清 C 反应蛋白（CRP）。此外，还评估了根据 SCORE 和 Framingham 量表的心血管风险。
在高血压组中，男女两性的 ABI 与 Framingham 量表均有显著相关性。在高血压女性中，IMT 与 SCORE 量表风险和 Framingham 量表风险也有显著相关性。在血压正常的女性中，ABI 与 SCORE 量表风险和 Framingham 量表风险有显著相关性。在血压正常的男性中，PWV 与 SCORE 量表风险和 Framingham 量表风险有显著相关性。最后，在血压正常的男性组中，IMT 与 SCORE 量表风险和 Framingham 量表风险有显著相关性。使用同步 ABI、IMT 和 PWV 的逻辑回归模型正确将患者分类为高危患者的可能性较高-SCORE 量表的风险为 74%（男性为 66%，女性为 88%），Framingham 量表为 98%。
将公认的亚临床靶器官损伤试验加入到心血管风险评估中，可以显著加强心血管疾病的预防。使用 ABI、PWV 和 IMT 进行心血管风险评估随访增加了正确将人群分类为高危人群的可能性，尤其是女性，根据 SCORE 量表，这具有有价值的治疗意义。
