Agac Mustafa Tarik, Ağaç Süret, Aksoy Muhammed Necati Murat, Vatan Mehmet Bülent
Department of Cardiology, Sakarya University Training and Research Hospital, Adapazarı, Turkey.
Department of Biochemistry, Sakarya University Training and Research Hospital, Adapazarı, Turkey.
Clin Exp Hypertens. 2021 May 19;43(4):349-355. doi: 10.1080/10641963.2021.1883052. Epub 2021 Feb 3.
: Identification of target organ damage and/or risk-enhancing factors help treatment decisions in hypertensive and hyperlipidaemic patients who reside in borderline to an intermediate risk category based on 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimates.: In the present study, we aimed to investigate the comparative efficacy of certain hypertension-mediated organ damage markers (HMOD) for the prediction of 10-year ASCVD risk ≥10%, in patients with primary hypertension without established CVD.: One-hundred thirty-seven asymptomatic hypertensive patients ≥40 years of age were enrolled in the present study. Ten-year ASCVD risks were estimated by Pooled Cohort Equations. The following HMOD markers; pulse pressure (PP), left ventricular mass index (LVMI), carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI) and estimated glomerular filtration rate (eGFR) were evaluated with respect to efficacy for predicting ≥10% ASCVD risk with ROC analysis.: CAVI gave the greatest Area Under Curve (AUC = 0.736, < .000), and followed by CIMT (AUC = 0.727, < .000), LVMI (AUC = O.630, = .01), and PP (AUC = 0.623, = .02). ABI and eGFR were not found to be predictive. CAVI correlated best with estimated 10-year ASCVD risk ( = 0.460, < .000). A CAVI value ≥8 was found 71% sensitive and 72% specific for predicting ≥10% risk in 10-year ASCVD risk scale. CAVI gave the best graded response to increments in 10-year ASCVD risk categories.: We suggest that CAVI is the best surrogate for 10-year ASCVD risk, among several HMOD markers.
根据10年动脉粥样硬化性心血管疾病(ASCVD)风险评估,识别靶器官损害和/或风险增强因素有助于处于临界至中度风险类别的高血压和高脂血症患者的治疗决策。:在本研究中,我们旨在调查某些高血压介导的器官损害标志物(HMOD)对预测10年ASCVD风险≥10%的比较疗效,研究对象为无已确诊心血管疾病的原发性高血压患者。:本研究纳入了137名年龄≥40岁的无症状高血压患者。通过合并队列方程估计10年ASCVD风险。对以下HMOD标志物;脉压(PP)、左心室质量指数(LVMI)、颈动脉内膜中层厚度(CIMT)、踝臂指数(ABI)、心踝血管指数(CAVI)和估计肾小球滤过率(eGFR)进行评估,以确定其预测≥10% ASCVD风险的疗效,并进行ROC分析。:CAVI的曲线下面积最大(AUC = 0.736,P <.000),其次是CIMT(AUC = 0.727,P <.000)、LVMI(AUC = 0.630,P =.01)和PP(AUC = 0.623,P =.02)。未发现ABI和eGFR具有预测性。CAVI与估计的10年ASCVD风险相关性最佳(r = 0.460,P <.000)。在10年ASCVD风险量表中,发现CAVI值≥8对预测≥10%风险的敏感性为71%,特异性为72%。CAVI对10年ASCVD风险类别增加的分级反应最佳。:我们建议,在几种HMOD标志物中,CAVI是10年ASCVD风险的最佳替代指标。