Key result
Atherosclerosis detection by carotid ultrasound led to a significantly higher proportion of lowered target LDL-C levels compared to negative CUS (52% vs 23%, P<0.001).
Why the study?
Does atherosclerosis detection by carotid ultrasound improve physician prevention efforts and LDL-C reduction in asymptomatic hypertensive subjects?
Cohort (n=347)
Yes
Does atherosclerosis detection by carotid ultrasound improve physician prevention efforts and LDL-C reduction in asymptomatic hypertensive subjects?
Absolute Event Rate: 52% vs 23%
p-value: p=<0.001
Detection of atherosclerosis by carotid ultrasound in asymptomatic hypertensive patients leads to more aggressive physician-targeted LDL-C goals and significant reductions in patient LDL-C levels.
May support carotid ultrasound to intensify LDL-C targets in asymptomatic hypertension; hypothesis-generating, needs RCTs to confirm outcomes.
BACKGROUND: There are limited data regarding the impact of atherosclerosis detection by carotid ultrasound (CUS) on physician prevention efforts and risk-factor management for cardiovascular disease. HYPOTHESIS: Atherosclerosis detection by CUS in asymptomatic hypertensive patients would lead to physician prevention efforts, including target low-density lipoprotein cholesterol (LDL-C) level and prescription. Also, it may improve risk-factor management. METHODS: A total of 347 asymptomatic hypertensive subjects (age 61 ± 8 years, 189 men) were prospectively recruited from 22 hospitals. Prior to CUS, physicians were surveyed regarding target LDL-C level. After CUS, patients were classified into positive CUS (n = 182) and negative CUS (n = 165) groups based on CUS results. Physicians were resurveyed to assess whether the initial target LDL-C goals were changed. At 6 months, cardiovascular risk-factor modification status was reassessed. RESULTS: The proportion of lowered target LDL-C levels was significantly larger in the positive CUS group than in the negative CUS group (52% vs 23%, P < 0.001). These results were observed even in subjects who had low and moderate risk according to National Cholesterol Education Program-Adult Treatment Panel III guidelines. Lipid-lowering agents were similarly added or switched to another class in both groups (7% in the positive CUS group vs 11% in the negative CUS group, P = 0.153). LDL-C was significantly decreased in the positive CUS group (Δ = -24 ± 38 mg/dL, P < 0.001), whereas it was not significantly decreased in the negative CUS group (Δ = -6 ± 31 mg/dL, P = 0.105). CONCLUSIONS: Atherosclerosis detection by CUS lowered physicians' target LDL-C level and improved cardiovascular risk management in terms of LDL-C reduction.
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Hong et al. (2013) conducted a cohort in Asymptomatic hypertension (n=347). Atherosclerosis detection by carotid ultrasound (positive CUS) vs. Negative CUS was evaluated on Proportion of lowered target LDL-C levels (p=<0.001). Atherosclerosis detection by carotid ultrasound led to a significantly higher proportion of lowered target LDL-C levels compared to negative CUS (52% vs 23%, P<0.001).
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