ABSTRACT
Objective: to assess the influence of carotid intima-media thickness in addition to traditional risk factors on cardiovascular risk assessment in hypertensive patients. Methods: 60 hypertensive patients ( 45 years) seen at the outpatient hypertension Clinic were included in the present study. They underwent the followings procedures: (i) medical history; physical examination and clinic blood pressure measurement; (ii) routine blood chemistry; (iii) carotid B mode ultrasound. Increased carotid IMT was defined as values 0.9 mm and 1.3 mm. 2007 ESH/ESC guidelines were used to assess cardiovascular risk. Chi square and Student t tests were used as appropriate. P value 0.05 defined the level ofstatistical significance. Results: according to 2007 ESH/ESC guidelines 5 (8); 16 (27); 25 (42) and 14 patients (23) were at low; moderate; high and very high risk; respectively. With the integration of cIMT; 5 (31) and 2 patients (8) initially at moderate and high risk; respectively; shifted from these categories to high and very high risk ones. The net reclassification improvement was 12for all the population. No changes were observed in initially low and very high risk patients. Conclusion: Carotid intima-media thickeness may improve cardiovascular risk stratification; mainly in moderate or intermediate risk hypertensive patients
Subject(s)
Black People , Cardiovascular Diseases , Hypertension , Risk FactorsABSTRACT
Objective. To assess the prevalence of increase carotid Intima-media thickness and associated risk factors in hypertensive patients. Methods. 60 consecutive hypertensive patients ( 45 years) seen at the outpatient hypertension Clinic were included in the present study. They underwent the following procedures: (i) medical history; physical examination and clinic blood pressure measurement; (ii) routine blood chemistry; (iii) carotid B mode ultrasound. Increased carotid IMT was defined as values 0.9 mm and 1.3 mm or values 75th percentile. 2007 ESH/ESC guidelines were used to assess cardiovascular risk. Univariate logistic regression analysis was used to evaluate risk factors associated with increased cIMT. P value 0.05 defined the level of statistical significance. Results. Increased IMT was present in 12and 32of patients using values 0.9 mm and 0.8 (75th percentile); respectively. Age 60 years (OR: 7.5; 95CI: 1.9-30; p = 0.003); diabetes 5 years (OR: 2.0; 95CI: 1.1-3.7; p = 0.016); hypertension 7 years (OR: 3.6; 95CI: 1.1-13; p = 0.029) and uric acid 7 mg/dl (OR: 4.6; 95CI: 1.4-15; p = 0.012) emerged as the main predictors of the risk of having increased cIMT. Conclusion. Increased IMT was common among the present case series; diabetes; hypertension and hyperuricemia; all components of the MetS; emerged as the main modifiable risk factors associated with increased cIMT. Therapeutic lifestyle changes should be encouraged in addition to antihypertensive therapy in these patients