Abstract
Objective: Different diagnostic procedures of subclinical vascular damage detection are now suggested but unequal impact of cardiovascular risk factors on arterial wall is still discussed. The aim of our study was to assess the prevalence of subclinical vascular changes and possibility to reveal hypertensive vascular damage according to different diagnostic methods. Design and Method: 1382 apparently healthy participants aged 25–65 years were randomly selected from Saint-Petersburg inhabitants (a sample form ESSE-RF study). All participants signed informed consent and filled in the questionnaire regarding risk factors, concomitant diseases and therapy. Fasting lipids, glucose, anthropometry and BP measurement were performed. Cardio-ankle vascular index (CAVI), ankle brachial index (ABI) and measurement of intima-media thickness (IMT) were performed. The subclinical vascular damage was detected, if CAVI ≥ 9.0, ABI ≤ 0.9, IMT > 0.9 mm. Participants with BP > 140/90 mmHg and/or under antihypertensive therapy were referred to hypertensive patients group. Statistical analysis was performed using SPSS Statistics 20. Results: Most of patients 955 (76.7%) did not have subclinical vascular damage by any of methods. The subclinical vascular damage detected by IMT assessment was found out significantly more often (212 (24.7%)) in comparison with CAVI (75 (8.7%)) and ABI (18 (2.1%)) assessments, p < 0.005. According to results of multiple logistic regression adjusted by age, probability to reveal subclinical vascular damage by CAVI (OR = 3.7, 95%CI = 2.6–5.3, p < 0.0001) was higher in comparison with IMT (OR = 2.8, 95%CI = 1.7–4.8, p < 0.0001) in hypertensive patients. ABI increasing was not associated with hypertensive vascular changes by any method. Conclusions: IMT assessment allows detecting subclinical vascular damage more often than the other methods in relatively healthy population. CAVI seems to give the opportunity to reveal subclinical vascular damage at earlier stages of hypertension in comparison with ultrasound vascular assessment.
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