ABSTRACT

Background: Identification of target organ damage and/or risk-enhancing factors help treatment decisions in hypertensive and hyperlipidaemic patients who reside in borderline to an intermediate risk category based on 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimates.

Aim: In the present study, we aimed to investigate the comparative efficacy of certain hypertension-mediated organ damage markers (HMOD) for the prediction of 10-year ASCVD risk ≥10%, in patients with primary hypertension without established CVD.

Methods: One-hundred thirty-seven asymptomatic hypertensive patients ≥40 years of age were enrolled in the present study. Ten-year ASCVD risks were estimated by Pooled Cohort Equations. The following HMOD markers; pulse pressure (PP), left ventricular mass index (LVMI), carotid intima-media thickness (CIMT), ankle-brachial index (ABI), cardio-ankle vascular index (CAVI) and estimated glomerular filtration rate (eGFR) were evaluated with respect to efficacy for predicting ≥10% ASCVD risk with ROC analysis.

Results: CAVI gave the greatest Area Under Curve (AUC = 0.736, p < .000), and followed by CIMT (AUC = 0.727, p < .000), LVMI (AUC = O.630, p = .01), and PP (AUC = 0.623, p = .02). ABI and eGFR were not found to be predictive. CAVI correlated best with estimated 10-year ASCVD risk (r = 0.460, p < .000). A CAVI value ≥8 was found 71% sensitive and 72% specific for predicting ≥10% risk in 10-year ASCVD risk scale. CAVI gave the best graded response to increments in 10-year ASCVD risk categories.

Conclusion: We suggest that CAVI is the best surrogate for 10-year ASCVD risk, among several HMOD markers.

抽象的

背景：确定目标器官损伤和/或风险增强因素有助于根据10年动脉粥样硬化性心血管疾病（ASCVD）风险估算，对处于中等风险类别的边缘的高血压和高脂血症患者进行治疗决策。

目的：在本研究中，我们旨在研究某些高血压介导的器官损伤标志物（HMOD）在没有建立CVD的原发性高血压患者中预测10年ASCVD风险≥10％的比较功效。

方法：本研究纳入了147名≥40岁的无症状高血压患者。通过合并队列方程估算了十年的ASCVD风险。以下HMOD标记；用通过ROC分析预测ASCVD风险≥10％的功效。

结果：CAVI的曲线下面积最大（AUC = 0.736，p <.000），其次是CIMT（AUC = 0.727，p <.000），LVMI（AUC = O.630，p = .01），和PP（AUC = 0.623，p = .02）。未发现ABI和eGFR具有预测性。CAVI与估计的10年ASCVD风险最相关（r = 0.460，p <.000）。在10年ASCVD风险量表中，发现CAVI值≥8敏感度为71％，特异性为72％，可预测≥10％的风险。对于10年期ASCVD风险类别中的增加，CAVI给出了最佳的分级响应。

结论：我们认为，在几种HMOD指标中，CAVI是10年ASCVD风险的最佳替代指标。