MULTIPLE LINEAR REGRESSION MODELS AND SUBCLINICAL ORGAN DAMAGE IN CARDIOVASCULAR RISK STRATIFICATION IN PATIENTS WITH OR WITHOUT HYPERTENSION

Abstract

Objective: Assessment of subclinical organ damage and sex differences in cardiovascular risk stratification in patients with or without hypertension. Design and method: We divided 100 patients in two groups: A: HT+: patients with arterial hypertension (25 women and 25 men); B: HT-: patients without arterial hypertension (25 women and 25 men). The average age of them [yrs]: 56 and 53 (*p < 0,05). Ankle-brachial index (ABI), pulse wave velocity (PWV) and carotid intima-media thickness (IMT) were evaluated. We assessed cardiovascular risk according to: SCORE and Framingham scales. Statistical calculations were performed in PQStat 1.6. For comparison of variables with a normal distribution and equal variances we used the t-test for unrelated samples. Logistic regression models were used in order to estimate the simultaneous impact of ABI, PWV and IMT on cardiovascular risk according to SCORE and Framingham scales. Results: We revealed following results in both groups: CAD-HT+ and CAD-HT- respectively [*for p < = 0,05; **for p < 0,001; NS- negligible statistically].In the group with hypertension women were characterized by a lower IMT and PWV than men. The cardiovascular risk according to risk SCORE and Framingham scales in men was significantly higher than in women in both groups. Taking into account ABI, PWV and IMT, the probability of correctly classifying a given patient to, at least, a high-risk category according to the SCORE scale was 74% (p = 0,0002; R2 Cox-Snell = 17,74%). For women, the probability was 88% (p = 0,0012; R2 Cox-Snell = 27,25%). In men, the probability was 66% (p = 0,0074; R2 Cox-Snell = 21,32%). Conclusions: 1. There was no difference in values of: ABI, PWV and IMT between the sexes in normotensive patients. 2. Women with hypertension were characterized by a lower IMT, PWV. 3. Cardiovascular risk estimation follow-up concerning ABI, PWV and IMT results increased the probability of correctly classifying women to, at least, a high-risk category according to the SCORE scale which, in the context of the higher mortality due to cardiovascular diseases in women, can provide valuable therapeutic implications.