Abstract
Early detection of atherosclerosis, i.e., in occupational health screening programs could reduce the rate of cardiovascular events in the working population. Changes of the augmentation index (AIX) correlate with changes of the arterial stiffness induced by aging, atherosclerosis, or arterial hypertension and have a prognostic value for cardiovascular events. Their diagnostic yield should be increased by normalizing the AIX to age, in terms of a calculating the vascular age (VA). In this pilot study, 30 patients (mean age 65.3 ± 8.8 years, 21 male) with suspected coronary heart disease underwent a duplex ultrasound of the carotid arteries and a measurement of the ankle brachial index in addition to the coronary angiography. The AIX was recorded with a portable device (Vascular Explorer), and the VA was calculated. Atherosclerosis was found in 24 patients. They were older than the patients without atherosclerosis, but there was no age dependency found for the distribution pattern or severity of atherosclerosis. In patients with findings of atherosclerosis, the calculated VA was higher than the chronological age, and these differences were significant in patients below 65 years of age. Comparing patients in higher blood pressure classes with patients in lower classes, significantly higher AIX, VA, and differences to the chronological age were found. The VA, deduced from the noninvasively obtained AIX, is a promising candidate for screening programs for atherosclerosis, i.e., in occupational health screening programs.
Highlights
Risk assessment for atherosclerosis is an important step in primary prevention of cardiovascular events to identify patients that should undergo more specific diagnostic strategies and medical interventions [1]
The intima media thickness (IMT) is an independent predictor of cardiovascular events [7]; its main disadvantage is the need of experienced investigators and high-frequency ultrasound probes for accurate measurements
RR class, classification of the blood pressure regulation according to the classification of the European Society of Cardiology [20]
Summary
Risk assessment for atherosclerosis is an important step in primary prevention of cardiovascular events to identify patients that should undergo more specific diagnostic strategies and medical interventions [1] Risk assessment models, such as the Framingham score or the European SCORE system, integrate several risk factors for fatal cardiovascular events, including hyperlipoproteinemia, hypertension, gender, and chronological age [2, 3]. Since the spatial resolution of ultrasound probes was high enough to directly visualize early stages of atherosclerosis, such as changes of the intima media thickness (IMT) in the carotid arteries, and age-dependent normal values had been described, individual values could be normalized to the chronological age. Its determination is not feasible for screening programs, i.e., in occupational health screening programs
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