Key result
Subclinical atherosclerosis assessment detected a 65% burden of subclinical atherosclerosis in non-diabetic hypertensive patients, resulting in 42% of patients being re-classified into the very high-risk category.
Why the study?
Identifying patients at high risk of cardiovascular disease in primary prevention is challenging, prompting evaluation of subclinical atherosclerosis burden in non-diabetic hypertensive patients in primary care.
Cross-Sectional (n=140)
No
In non-diabetic hypertensive patients in primary care, screening for subclinical atherosclerosis reclassified 42% of patients into the very high-risk category, highlighting significant undertreatment with lipid-lowering therapies.
BACKGROUND: Identifying patients at high risk of cardiovascular disease in primary prevention is a challenging task. This study aimed at detecting subclinical atherosclerosis burden in non-diabetic hypertensive patients in a primary care centre. METHODS: Clinical, anthropometric and analytical data were collected from patients with hypertension who were free from clinical vascular disease and diabetes. The cardiovascular risk was assessed using the SCORE system. Subclinical atherosclerosis burden was assessed by carotid ultrasonography (intima-medial thickness [IMT] and plaque) and measurement of the ankle-brachial index (ABI). RESULTS: Out of 140 patients, 59 (42%) have carotid plaque, 32 (23%) have IMT higher than 75% and 12 (9%) have an ABI < 0.9. Total atherosclerosis burden was present in 91 (65%) of the subjects. Consequently, 59 (42%) patients were re-classified into the very high-risk category. In multivariate analyses, smoking, creatinine levels and duration of hypertension were associated with atherosclerosis burden. In contrast, only smoking and age were associated with the presence of carotid plaque. Almost 90% of patients were treated with hypotensive drugs, half of them combined several drugs and 60% were well-controlled. Only 30% received statins in monotherapy and only less than 20% had an LDL cholesterol < 100 mg/dL. CONCLUSIONS: In non-diabetic hypertensive patients managed at a primary care centre, 4 out of 10 had subclinical atherosclerosis burden and were re-classified into the very high- risk category. There was clear undertreatment with lipid-lowering drugs of most LDL cholesterol inappropriate levels, according to current clinical guidelines.
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Torres et al. (2023) conducted a cross-sectional in Hypertension (n=140). Subclinical atherosclerosis assessment (carotid ultrasound and ABI) was evaluated on Presence of subclinical atherosclerosis burden (ATB). Subclinical atherosclerosis assessment detected a 65% burden of subclinical atherosclerosis in non-diabetic hypertensive patients, resulting in 42% of patients being re-classified into the very high-risk category.
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