Prevalence of subclinical atherosclerosis and cardiovascular risk reclassification by measure of carotid intima-media thickness in ambulatory hypertensive patients

• Published in: Revista portuguesa de cardiologia Vol. 32; no. 12; pp. 975 - 980
• Main Authors: Monteiro Júnior, Francisco das Chagas, Pereira da Cunha Júnior, Cacionor, Muniz Ferreira, Pedro Antônio, Teixeira Nunes, José Aldemir, Lopes Brito, Ronald, Barbosa, José Bonifácio, Ribeiro Mandarino, Natália, Santos Lages, Joyce, Salgado Filho, Natalino, Correia de Lima, Valter
• Format: Journal Article
• Language: Portuguese
• Published: Portugal 01-12-2013
• Subjects: Ambulatory Care; Atherosclerosis - complications; Atherosclerosis - epidemiology; Cardiovascular Diseases - complications; Cardiovascular Diseases - epidemiology; Carotid Intima-Media Thickness; Cross-Sectional Studies; Female; Humans; Hypertension - complications; Male; Middle Aged; Prevalence; Risk Assessment; Hypertension; Estratificação de risco; Hipertensão; Espessura íntimo-medial carotídea; Risk assessment; Carotid intima-media thickness
• ISSN: 2174-2030
• DOI: 10.1016/j.repc.2013.04.016

Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. The aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients.
This was a cross-sectional study of 94 middle-aged (56.99±11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound.
Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk.
In these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases.