Association of Framingham score with the parameters of ambulatory blood pressure monitoring

Abstract

Cardiovascular complications are a major public health problem. The Framingham Risk Score (FS) is a scoring system that assesses the 10-year risk of cardiovascular event. The objective of our study was to evaluate the association of this score with the different parameters of the ambulatory blood pressure monitoring (ABPM). We carried out a retrospective study including patients having an ABPM between January 2015 and December 2016. The FS of each patient was calculated according to the AHA recommendations, including the following parameters: age, sex, smoking, office blood pressure, body mass index, treatment of hypertension and diabetes. The comparison between the groups was carried out by One-Way ANOVA test, and the correlation between FS and ABPM parameters by the Pearson coefficient. A total of 231 patients were included, sex-ratio M/F = 0.83. The results of ABPM showed uncontrolled hypertension (37.2%), controlled hypertension (30.3%), masked hypertension (18.6%) and absence of hypertension (13.9%). Patients with uncontrolled hypertension had the highest FS (35.5 ± 26, P < 0.001). Patients without hypertension had the lowest FS (9.4 ± 10, P < 0.001). The mean FS were 20 ± 19%, 27 ± 24%, 35 ± 30%, 38 ± 28% respectively in the dippers, non-dippers, hyper-dippers and risers ( P = 0.001). Patients with nocturnal hypertension had a higher FS than other patients (29 ± 25 vs. 23 ± 22, P = 0.06). The correlation study showed that FS was negatively correlated with glomerular filtration rate ( r = −0.35, P < 0.001). FS was positively correlated with mean global systolic blood pressure ( r = 0.16, P = 0.017), mean diurnal systolic blood pressure ( r = 0.14, P = 0.4), and mean nocturnal systolic blood pressure ( r = 0.2, P = 0.002). The Framingham score is higher in patients with riser profile and nocturnal hypertension. The ABPM parameters correlated to the Framingham score are 24-hour systolic BP, diurnal systolic BP, and nocturnal systolic BP. Adequate management of other risk factors could balance the blood pressure profile, reduce cardiovascular risk and thus ensure a better quality of life for these patients.