P1.49 Evaluation of Arterial Stiffness and Cardiovascular Risk Stratification in a General Population in Northern Italy. The Vobarno Study

Abstract

Hypertension guidelines underline the importance of quantification of total cardiovascular(CV)risk;an extensive evaluation of target organ damage (TOD)may increase the number of patients classified at high CV risk.The aim of our study was to assess the effect of the evaluation of different forms of TOD,in addition to ‘‘routine’’ work-up,on CV risk(CVR)stratification in a general population.

Methods

In 385 untreated subjects(age 57±10 years,44% males,64% hypertensives(HT),32% treated)left ventricular and carotid artery structure and carotido-femoral PWV were measured. All subjects underwent laboratory examinations.Subjects were divided into risk categories according to ESH/ESC guidelines before and after TOD evaluation.

Results

After routine work up patients were classified as follows:7% at average CVR,35% at low CVR,26% at moderate CVR,31 at high CVR and 1% at very high CVR. The proportion of patients at low or moderate CVR reclassified at high CVR were 6%,12%,14% and 32% after echocardiography, albuminuria, PWV and carotid ultrasound(CUS) respectively(X2 p<0.001 for all vs routine). Assessment of PWV in addition to echocardiography lead to an increase of the proportion of patients at high CVR (from 6% to 17%,p<0.001),as for PWV in addition to albuminuria (from 12 to 22%,p<0.01)but did not affect risk stratification in addition to CUS(from 32% to 35%, p ns).

Conclusion

Measurement of PWV may significantly change CVR stratification in addition to echocardiography and to detection of albuminuria, but not after CUS;our results confirm that evaluation of different forms of TOD is useful for a more accurate assessment of global CVR.