¿Cómo y por qué calculamos el riesgo vascular en el paciente hipertenso?

Abstract

Cardiovascular risk assessment is of key importance for a global diagnosis of the hypertensive patient. Card iovascular risk stratification accord ing blood pressure levels, presence of accompanying cardiovascular risk factors, and presence of subclinical and/or clinical organ damage, constitute a systematic approach to assess risk for cardiovascular morbidity and mortality, to decide about initial antihypertensive treatment, and to promote global cardiovascular risk management. Several recent clinical practice guidelines recommend this approach, although there are no clinical trials demonstrating advantages of this management versus treating cardiovascular risk factors individually. Guidelines for management of high blood pressure and that for management of dyslipidemias constitute examples of agreement about the convenience of assessing global cardiovascular risk. Both qualitative (European guidelines for management of arterial hypertension) and quantitative (SCORE) tables are available, both useful for id entification of high-risk patients, and indicating the necessity of starting simultaneous non-pharmacological and pharmacological treatment.Family doctors should include in their usual clinical practice a systematic approach to cardiovascular risk assessment, thus diagnosing the individual cardiovascular risk burden, and consequently applying therapeutic management to reduce future risk of cardiovascular morbidity and mortality.