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March 11, 2014HypertensionOpen Access

Common Carotid Intima-Media Thickness Measurements Do Not Improve Cardiovascular Risk Prediction in Individuals With Elevated Blood Pressure

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Why the study?

Does the addition of mean common carotid intima-media thickness to the Framingham Risk Score improve 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure?

Population

17,254 asymptomatic individuals with elevated blood pressure pooled from 16 studies in the USE-IMT…

Comparison

Addition of mean common carotid intima-media… vs Framingham Risk Score alone (baseline model)

Design

Meta-analysis

Follow-up

median 9.9 years

Authors

MBMichiel L. BotsPreventive CardiologyKGKarlijn A. GroenewegenSlotervaartziekenhuisTATodd J. AndersonInterventional Cardiology

Discussion

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Implication

Does not support adding CIMT to Framingham Risk Score for CVD prediction in elevated BP; reinforces limited incremental value of imaging markers beyond traditional factors.

Structured PICO

Does the addition of mean common carotid intima-media thickness to the Framingham Risk Score improve 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure?

P
Population
17,254 asymptomatic individuals with elevated blood pressure (systolic blood pressure ≥140 mm Hg and diastolic blood pressure ≥ 90 mm Hg) pooled from 16 studies in the USE-IMT individual participant data meta-analysis.
I
Intervention
Addition of mean common carotid intima-media thickness (CIMT) measurement to the Framingham Risk Score (CIMT model)
C
Comparator
Framingham Risk Score alone (baseline model)
O
Outcome
10-year risk of first-time myocardial infarction or stroke (assessed via discrimination, calibration, and net reclassification improvement)hard clinical

Routine measurement of carotid intima-media thickness does not meaningfully improve cardiovascular risk prediction beyond standard risk factors in patients with elevated blood pressure, though it offers a small statistical improvement for intermediate-risk patients.

Cite This Study

Bots et al. (2014) studied this question.

synapsesocial.com/papers/6a82a2b1040bdabcf346f8b1https://doi.org/10.1161/hypertensionaha.113.02683

Topics

Hypertension managementWomen and heart diseaseCardiovascular prevention
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Determinants of carotid intima‐media thickness: a population‐based ultrasonography study in Eastern Finnish men1991 · 568 citations
  2. 2Association of Carotid Artery Intima-Media Thickness, Plaques, and C-Reactive Protein With Future Cardiovascular Disease and All-Cause Mortality2007 · 348 citations
  3. 3Role of echocardiography and carotid ultrasonography in stratifying risk in patients with essential hypertension: the Assessment of Prognostic Risk Observational Survey2002 · 190 citations
  4. 4Long-term health benefits and costs of measurement of carotid intima–media thickness in prevention of coronary heart disease2013 · 18 citations
  5. 5Common carotid intima-media thickness in cardiovascular risk stratification of older people: the Rotterdam Study2011 · 72 citations