Cardiovascular Risk Assessment Tools Research Articles

Reliability between Cardiovascular Risk Assessment Tools: A Pilot Study

Abstract Background The prevention of cardiovascular disease (CVD) is important in clinical practice due to its high morbidity and mortality. Different guidelines have recommended the use of different cardiovascular risk assessment tools, which may have implications on therapeutic decisions. Objective To evaluate the agreement rate between the Framingham risk score (FRS) and the Systematic Coronary Risk Evaluation (SCORE) tool on CVD risk assessment in disease-free subjects. Methods Cross-sectional study with a sample of 51 subjects treated at the outpatient clinic [...]

Agreement between cardiovascular disease risk assessment tools: An application to the United Arab Emirates population.

IntroductionEvidence regarding the performance of cardiovascular disease (CVD) risk assessment tools is limited in the United Arab Emirates (UAE). Therefore, we assessed the agreement between various externally validated CVD risk assessment tools in the UAE.MethodsA secondary analysis of the Abu Dhabi Screening Program for Cardiovascular Risk Markers (AD-SALAMA) data, a large population-based cross-sectional survey conducted in Abu Dhabi, UAE during the period 2009 until 2015, was performed in July 2019. The analysis included 2,621 participants without type 2 Diabetes and without history of cardiovascular diseases. The CVD risk assessment tools included in the analysis were the World Health Organization for Middle East and North Africa Region (WHO-MENA), the systematic coronary risk evaluation for high risk countries (SCORE-H), the pooled cohort risk equations for white (PCRE-W) and African Americans (PCRE-AA), the national cholesterol education program Framingham risk score (FRAM-ATP), and the laboratory Framingham risk score (FRAM-LAB).ResultsThe overall concordance coefficient was 0.50. The agreement between SCORE-H and PCRE-W, PCRE-AA, FRAM-LAB, FRAM-ATP and WHO-MENA, were 0.47, 0.39, 0.0.25, 0.42 and 0.18, respectively. PCRE-AA classified the highest proportion of participants into high-risk category of CVD (16.4%), followed by PCRE-W (13.6%), FRAM-LAB (6.9%), SCORE-H (4.5%), FRAM-ATP (2.7%), and WHO-MENA (0.4%).ConclusionsWe found a poor agreement between various externally validated CVD risk assessment tools when applied to a large data collected in the UAE. This poses a challenge to choose any of these tools for clinical decision-making regarding the primary prevention of CVD in the country.

Relationship Between Cardiovascular Disease Risk with Depression and Retirement in the Turkish Population

Objective: The present study identifies the factors that can be linked to coronary artery disease, and evaluates the effect of retirement on the development of cardiovascular diseases in the Turkish population. Methods: This cross-sectional study was carried in the Family Health Centers between March and July 2019. The data was collected using the Beck Depression Inventory and Framingham general cardiovascular disease risk assessment tool, sociodemographic form. Results: The mean Framingham risk score of the respondents was 6.440±7.509. A statistically significant relationship was identified between the Framingham risk score and income perception, monthly net income, occupation, educational status, marital status and employment (p<0.05). When the factors related to the Framingham risk score were evaluated, retirement was found to increase the Framingham risk score 13.991 fold (p<0.05). Conclusion: It is worthy of note that the risk of cardiovascular disease is high in the Turkish population. Retirement was found to be the most influential variable on the risk of developing cardiovascular disease. It is important to organize health training programs on the prevention of heart disease and to develop appropriate health policies.

Assessing utility of a lifestyle-based tool in the clinical setting as a primordial prevention strategy: The Healthy Heart Score.

To evaluate the opinions of primary health-care providers and patients regarding the use of the Healthy Heart Score 20-year cardiovascular disease risk assessment tool in the clinical setting. Semi-structured in person or phone interviews among 20 patients with no self-reported cardiovascular disease diagnoses and 20 health-care providers in Central (Columbus) and Southeastern (Athens) regions of Ohio. The researchers independently coded transcribed interviews, discussed codes to resolve discrepancies, and agreed on common themes. Participants suggested ways to best utilize and improve the tool, including adding graphics for visual reference of serving size. Patients showed interest in cardiovascular disease primordial prevention and expressed willingness to take the assessment prior to seeing a health-care provider. Health-care providers said that they would recommend the assessment to their patients and would be willing to use the tool in their practice. Health-care providers stated few barriers to using the tool, yet discussed numerous challenges to successful primordial prevention. Our findings support the utilization of the Healthy Heart Score as a cardiovascular disease primordial prevention tool in the clinical setting. Additional research implementing the tool into the clinical setting will provide deeper insight into how the tool can impact behavior change and cardiovascular disease prevention.

Cardiovascular Risk Prediction using JBS3 Tool: A Kerala based Study.

Accuracy of Joint British Society calculator3 (JBS3) cardiovascular (CV) risk assessment tool may vary across the Indian states, which is not verified in south Indian, Kerala based population. To evaluate the traditional risk factors (TRFs) based CV risk estimation done in Kerala based population. This cross-sectional study uses details of 977 subjects aged between 30 and 80 years, recorded from the medical archives of clinical locations at Ernakulum district, in Kerala. The risk categories used are Low (<7.5%), Intermediate (≥7.5% and <20%), and High (≥20%) 10-year risk classifications. The lifetime classifications are Low lifetime (≤39%) and High lifetime (≥40%) are used. The study evaluated using statistical analysis; the Chi-square test was used for dependent and categorical CV risk variable comparisons. A multivariate ordinal logistic regression analysis for the 10-year risk and odds logistic regression analysis for the lifetime risk model identified the significant risk variables. The mean age of the study population is 52.56±11.43 years. With 39.1% in low, 25.0% in intermediate, and 35.9% has high 10-year risk. Low lifetime risk with 41.1%, the high lifetime risk has 58.9% subjects. The intermediate 10-year risk category shows the highest reclassifications to High lifetime risk. The Hosmer-Lemeshow goodness-of-fit statistics indicates a good model fit. Timely interventions using risk predictions can aid in appropriate therapeutic and lifestyle modifications useful for primary prevention. Precaution to avoid short-term incidences and reclassifications to a high lifetime risk can reduce the CVD related mortality rates.

Evaluation of the relationship between blood cell parameters and vascular calcification in dialysis-dependent end-stage renal disease patients.

Coronary artery calcification is an acceptable tool for cardiovascular risk assessment in end-stage renal disease (ESRD) population. We aimed to identify the association and predictive value of components of blood cell parameters with coronary and thoracic aorta vascular calcification (VC) in ESRD population on dialysis. All ESRD patients receiving hemodialysis or peritoneal dialysis aged between 18 and 60 years were included in the study. Exclusion criteria comprised patients with active infection or inflammatory disease, autoimmune disease, congestive heart failure, angina pectoris and/or documented coronary artery disease, thyroid disease, and hepatic dysfunction. Agatston scoring was used for the evaluation of coronary aorta calcification (CAC) score (CACS) and thoracic aorta calcification (TAC) score (TACS). Compared to participants with no VC, those who had VC were statistically significantly older (P <0.001) and had higher neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) (P = 0.02 and <0.001, respectively). On multivariate logistic regression analysis, increasing age (P = 0.00) and higher PLR (P = 0.04) were associated with an increased likelihood of exhibiting VC (CAC or TAC). There was a positive correlation between CACS and age (rs = 0.495, P = 0.00). A statistically significant positive correlation existed between TACS and age (rs = 0.516, P = 0.00). Similarly, a positive correlation was found between NLR, PLR, and TACS (rs = 0.334, P = 0.001, and rs = 0.438, P = 0.00, respectively). On multivariate linear regression analysis, increased age and red cell distribution width were found to be significant predictors of log(n) TACS. PLR of 135 gave a sensitivity of 80% and a specificity of 50% for predicting VC. Being a cost-effective and easily available investigation, the utilization of the correlation of NLR and PLR with CAC and TAC appears promising, particularly in the age group of 30-60 years.

Comparison and Implication of the Contemporary Blood Pressure Guidelines on Korean Population.

Background and ObjectivesThis study compared the potential impacts of the 2017 American College of Cardiology/American Heart Association (ACC/AHA) and the 2018 Korean Society of Hypertension (KSH) guidelines on prevalence of hypertension, recommended antihypertensive treatment, and achievement of target blood pressure (BP) in Korean population.MethodsWe analyzed the 2007–2017 Korea National Health and Nutrition Examination Survey data to calculate guideline-specific hypertension prevalence and treatment implications on 59,767 adults aged 20 years or older by sex and age.ResultsThe prevalence of hypertension was markedly higher 46.3% by the ACC/AHA guideline due to the lowered BP cutoff than 25.9% by the KSH guideline; the increase was most pronounced in young adults. Yet, there was only a marginal 1.6% increase in the percentage of adults suggested pharmacological approach by the ACC/AHA guideline, but selectively in the older subgroups. Overall, 45.6% of Korean adults treated for hypertension failed to meet BP goal according to the KSH guideline; the underachievement extended to 61.7% of participants according to the ACC/AHA guideline.ConclusionsThe lowered BP threshold, 130/80 mmHg, by the 2017 ACC/AHA guideline, in conjuncture with 10-year risk calculation largely driven by age, would increase pharmacological treatment preferentially in very old individuals, while increasing prevalence and uncontrolled rate mostly in younger subgroups. Adoption of lower BP cutoff to the KSH guideline would require validated cardiovascular disease risk assessment tools accounting for risk distributions specific to Korean population.

PS1183 THE POTENTIAL IMPACT OF SWITCH TO SECOND GENERATION TYROSINE KINASE INHIBITORS IN CHRONIC MYELOID LEUKEMIA PATIENTS IN CHRONIC PHASE WHO HAD NO OPTIMAL RESPONSE TO 3 MONTHS OF INITIAL IMATINIB THERAPY

Background: Response to tyrosine kinase inhibitor (TKI) treatment is a key predictor of outcome in chronic myeloid leukaemia (CML), as outlined in the European LeukemiaNet recommendations in 2013 [ELN2013]. ELN2013 define responses as “optimal”, “warning” or “failure” at specific milestones to guide TKI therapy switch. However, it is unclear how ELN2013 are implemented in routine clinical practice. In addition, the documentation of clinical characteristics, such as cardiovascular (CV) risk factors, which might impact treatment decisions in real world practice is not well understood. Furthermore, achievement of deep molecular response (DMR; BCR-ABL1IS ≤0.01%) a goal for treatment-free remission, outside of trials is not well described. Here we report the final results for the UK TARGET CML study of real world management of CML and the observed outcomes. Aims: Evaluate TKI treatment pathways, monitoring patterns and responses in UK patients (Pts) with CML against ELN2013 to inform future clinical practice. Methods: Retrospective observational study (sponsor Novartis UK) at 21 UK centres; Pt characteristics, TKI choice and responses were collected with consent by medical record review in 257 adult chronic phase CML Pt (≥18 years (y)). Data was analysed using descriptive statistics when all Pts had ≥13 months (m) follow-up (final data cutoff June 6, 2018). Results: Median (mdn) follow-up of all 257 Pts was 33m (range [r] 13–59m); mdn age 53.5y (r 18–92y) (144[56%] were male). Sokal and EUTOS score, documented in 96/257 and 36/257 respectively, appeared not to influence TKI choice (31/42 high risk Sokal Pts received first-line (1L) imatinib). Most Pts (203/257) received 1L imatinib (50 nilotinib, 4 dasatinib). Pts receiving second generation (2G) TKI were younger (mdn age imatinib 55y [r 18–92y] versus 2GTKI 46y [r 20–79.5y]). Overall 149/257 (58%) had ≥1 recorded baseline comorbidity (81/257 with CV comorbidities). Several CV risk factors were poorly documented at baseline for all Pts including blood pressure (74/257), blood glucose (60/257), and cholesterol (40/257) (documentation prior to 1L 2GTKI use was 12/54, 20/54, and 11/54, respectively). Also CV risk assessment tools such as “QRISK2” were poorly documented (3/257). Frequency of 1L molecular or cytogenetic assessments was 83% (186/223), 76% (151/199), and 69% (117/170) at 3, 6, and 12m respectively. An ELN failure response was observed in 48/223, and post failure 11/48 remained on 1L with median follow-up post failure of 14m (r 6–34m). Overall 113/257 (44%) switched TKI at least once (54/257 (21%) >1 switch). Main reasons for switch from 1L were resistance (73/113 [mutation analysis was performed in 20/73 prior to switch]) and intolerance (38/113). On second-line (2L), frequency of response testing at 3, 6, and 12m was 79% (65/82), 68% (45/66) and 52% (27/52), respectively. Overall 10/257 Pts had disease progression (1L imatinib n = 9; 1L 2GTKI n = 1). Table 1 summarises observed responses.Summary/Conclusion: In this real-world UK cohort with mdn follow-up of <3y, 44% of patients switched TKI at least once. DMR was observed in real world practice even in Pts switching TKI following an ELN failure or documented resistance. The final findings demonstrate ELN2013 are not universally implemented in UK practice with respect to the timing of monitoring, performance of mutational analysis, and management of Pts with an ELN failure. In addition we now also report that important baseline data such as CV risk factors were poorly documented, highlighting key areas for improvement for optimal Pt management in the UK.

A17325 Risk Assessment Tool in Cardiovascular Disease

Objectives: The study aimed to seek common points and significant differences of cardiovascular risk assessment tools used in coronary heart disease (CHD) guidelines. Methods: CHD Guidelines published with recommendations on risk assessment tool from January 2007 to September 2017 were searched in MEDLINE, EMBASE, and websites of guideline organizations and professional societies. Reviewers independently appraised quality of guidelines by using the six-domain Appraisal of Guidelines for Research and Evaluation II (AGREE II) tool. A guideline was “strongly recommended” if most domains (4 or more) scored above 60%. Full extraction of recommendations was performed for further evaluation. Results: Of 14 included guidelines, seven different assessment tools were used. The AGREE II scores of selected guidelines varied from 42% to 90% (average 65%). All guidelines recommended traditional risk factors for cardiovascular disease (CVD), but novel biomarkers of atherosclerosis were not recommended. No consensus on recommendations of target population, screening tests, CVD risk stratification or treatment thresholds. Conclusion: Quality of guidelines for risk assessment tools in CHD was relatively high. CVD risk assessment was necessary and important, though there was no consensus on optimum screening tools. Further studies are needed to improve cardiovascular risk prediction equations.

GW29-e1253 Risk Assessment Tool in Cardiovascular Disease: a Critical Appraisal of Coronary Heart Disease Guidelines

The study aimed to seek common points and significant differences of cardiovascular risk assessment tools used in coronary heart disease (CHD) guidelines. CHD Guidelines published with recommendations on risk assessment tool from January 2007 to September 2017 were searched in MEDLINE, EMBASE, and

Development and current status of cardiovascular disease risk assessment at home and abroad

Cardiovascular risk assessment tool can assist clinicians to identify people of different risk levels of cardiovascular disease, to implement classified intervention, and to provide personalized preventive and therapeutic measures. Various cardiovascular risk assessment tools have been reported based on different ethnic groups both at home and abroad. This article reviews cardiovascular risk assessment tools currently used at home and abroad, to provide reference for prevention and control strategies of cardiovascular diseases. Key words: Cardiovascular disease; Risk assessment

Deep Learning for Quantification of Epicardial and Thoracic Adipose Tissue From Non-Contrast CT.

Epicardial adipose tissue (EAT) is a visceral fat deposit related to coronary artery disease. Fully automated quantification of EAT volume in clinical routine could be a timesaving and reliable tool for cardiovascular risk assessment. We propose a new fully automated deep learning framework for EAT and thoracic adipose tissue (TAT) quantification from non-contrast coronary artery calcium computed tomography (CT) scans. The first multi-task convolutional neural network (ConvNet) is used to determine heart limits and perform segmentation of heart and adipose tissues. The second ConvNet, combined with a statistical shape model, allows for pericardium detection. EAT and TAT segmentations are then obtained from outputs of both ConvNets. We evaluate the performance of the method on CT data sets from 250 asymptomatic individuals. Strong agreement between automatic and expert manual quantification is obtained for both EAT and TAT with median Dice score coefficients of 0.823 (inter-quartile range (IQR): 0.779-0.860) and 0.905 (IQR: 0.862-0.928), respectively; with excellent correlations of 0.924 and 0.945 for EAT and TAT volumes. Computations are performed in <6 s on a standard personal computer for one CT scan. Therefore, the proposed method represents a tool for rapid fully automated quantification of adipose tissue and may improve cardiovascular risk stratification in patients referred for routine CT calcium scans.

Metabolic syndrome and cardiovascular risk assessment tools’ estimations of 10-year cardiovascular risk: a population-based study

Background: This cross-sectional study determines the association between 10-year cardiovascular disease (CVD) risk, estimated using four CVD risk assessment tools, and metabolic syndrome (MetS) in northern Iranian general population. Methods: We used the data of 2371 participants aged 40–74 without any history of diabetes mellitus from a cohort study conducted among 6140 subjects aged 10–90 years in northern Iran. Three definitions of MetS were used. The four CVD risk assessment tools used to estimate the 10-year CVD risk included pooled cohort equations of ACC/AHA, Systematic Coronary Risk Evaluation (SCORE) equations (for low-risk and high-risk European countries), and Framingham general cardiovascular risk profile for use in primary care. Logistic regression was used to determine the association between various definitions of MetS and 10-year CVD risk of ≥5%, ≥ 7.5%, and ≥10%, based on the related risk assessment tools. Results: In men, univariate logistic regression analysis showed the strongest association between 10-year risk of ≥0.1 estimated by Framingham risk profile and the three definitions of MetS. In women, the 10-year risks by Framingham risk profile and SCORE equations for high-risk European countries had stronger associations with various definitions of MetS than others. No significant associations were detected between estimated risks of four risk assessment tools and various definitions of MetS in multivariate logistic regression analyses. Conclusion: No independent associations were observed between estimations of 10-year CVD risk using four risk assessment tools and various definitions of MetS.

Cardiovascular risk prediction model for Omanis with type 2 diabetes

AimTo date, no cardiovascular risk assessment tool has been developed specifically for any Arabian population including Omanis. This study aims to develop a suitable cardiovascular risk prediction model in the form of a statistical equation, for Omanis with type 2 diabetes. Materials and methodsA sample of 2039 patients with type 2 diabetes selected from primary care settings in the Aldakhiliyah Province of Oman were involved in a retrospective cohort study. All patients were free of cardiovascular disease at baseline (in 2009–2010) and were followed up until: 1) their first cardiovascular event occurred; 2) the patient died, or 3) the end of the data collection in December 2015. ResultsAmong the total sample, 192 cardiovascular disease events were recorded within a mean follow-up period of 5.3-year. The 5-year probability of a cardiovascular event was given as 1−0.9991Exp∑XiBi, where Exp ∑XiBi (hazard ratio)=Exp (0.038 age+0.052 DM duration+0.102 HbA1c+0.201 total cholesterol+0.912 albuminuria [1 if present]+0.166 hypertension [1 if present]+0.005 BMI). ConclusionThe first cardiovascular risk prediction tool in the Arab world was developed in this study. It may be used to estimate the 5-year cardiovascular risk among Omanis with type 2 diabetes in order to plan patient management and preventive measures. However, further validation studies are required to determine the accuracy of the model.

Technology Dependence of Intima-Media Thickness Ultrasonographic Measurements

Introduction Ultrasonographic (US) measurements of intima-media thickness (IMT), particularly of the carotid arteries, have been used as a cardiovascular risk assessment tool. Variations in manual and semiautomatic measurements were investigated in an animal model—the aorta of 10 rabbits with dyslipedemia. Methods IMT was measured in B-mode images with 256 shades of gray using a 10 MHz probe by two independent investigators: (a) three same-place manual measurements were averaged in five distinct locations of the aorta of each rabbit for a total of 50 measurements per investigator (subgroups M1 and M2); (b) experimental software allowed for alterations in blood-intima and media-adventitia brightness line definition for IMT detection; observer 1 used brightness 50–200, adaptable to all images (SA1); observer 2 started with 10–60—the usual for human carotid measurements in this package—and increased values until IMT lines were visually acceptable; IMT was measured at optimized values for each image (SA2). Mean values were compared by using the paired t-test available in Excel. Results SA1 measurements, 0.379 ± 0.112 (SD) mm, were significantly smaller than SA2, 0.403 ± 0.122 mm, M1, 0.404 ± 0.149 mm, and M2, 0.405 ± 0.140 mm (&lt;0.001 for all three SA1 versus SA2, M1 and M2 comparisons). Conclusion/Discussion Distinct automatic technologies, including (a) selection of blood-intima and media-adventitia brightness interfaces and (b) signal processing to “improve” line images, may alter IMT measurements significantly. Assumed population variations may be affected by technology used. IMT gender and age tables may be applicable only if the same measurement technology was used consistently.

Prognostic value of exercise capacity among men undergoing pharmacologic treatment for erectile dysfunction: The FIT Project.

Vascular erectile dysfunction (ED) has been identified as a potentially useful risk factor for predicting future cardiovascular events, particularly in younger men. Because these men typically score more favorably on traditional cardiovascular disease risk assessment tools, there exists a gap in knowledge for how to most appropriately identify those men who would benefit from more aggressive treatments. To date, no studies have examined the impact of fitness on cardiovascular outcomes in men with ED. This study sought to examine the prognostic impact of maximal exercise capacity on cardiovascular-related outcomes in men ages 40 to 60 years being treated for ED. We hypothesized that there would be an independent association between higher baseline fitness level and lower cardiovascular events. We analyzed 1152 men with pharmacy claims file-confirmed active pharmacologic treatment for ED from the Henry Ford Exercise Testing (FIT) Project (1991-2009). All patients were free of coronary heart disease and heart failure, and underwent clinician-referred exercise stress testing, with fitness measured in metabolic equivalents of task (METs). Multivariable Cox proportional hazard models adjusted for traditional cardiovascular risk factors were used to study the association between fitness and all-cause mortality, major adverse cardiovascular events (MACE) (defined as myocardial infarction or revascularization), and incident type 2 diabetes mellitus. The mean age of the population was 53 years, with 39% African Americans. In multivariable analysis, each 1 MET of fitness was associated with a 16% lower risk of death (hazard ratio [HR]: 0.84, 95% confidence interval [CI]: 0.76-0.94, P = 0.002), and a nonsignificant reduction in MACE (HR: 0.89, 95% CI: 0.79-1.003, P = 0.048), and incident diabetes (HR: 0.92, 95% CI: 0.85-1.01, P = 0.129). Higher baseline fitness is associated with improved cardiovascular prognosis in a population of middle-aged men treated for ED.

Atherosclerotic Cardiovascular Risk in Japan.

Increased global mortality is associated with atherosclerosis, which appears to be independent of race. Cardiovascular disease is one of the leading causes of mortality and morbidity in Japan. Atherosclerosis, an inflammatory disease characterized by abnormal lipid accumulation and inflammation in the arterial wall, is the main underlying cause of cardiovascular disease. Numerous cardiovascular risk scores have been developed and are used to prioritize patients’ treatment needs. The predictive performance of risk scores established in Western nations needs to be examined in Japanese populations. For secondary prevention, it is imperative to control hypertension, hyperlipidemia, diabetes mellitus, smoking, and local interventions. In this review, we present a historical overview of atherosclerotic risk research and the risk factors for atherosclerosis in Japan and compare the situation in Japan with that in Western nations. In addition, we discuss relevant cardiovascular risk assessment tools in the context of clinical practice in Japan.

The time is ripe to reevaluate the second derivative of the digital photoplethysmogram (SDPTG), originating in Japan, as an important tool for cardiovascular risk and central hemodynamic assessment

The time is ripe to reevaluate the second derivative of the digital photoplethysmogram (SDPTG), originating in Japan, as an important tool for cardiovascular risk and central hemodynamic assessment

Comparison of cardiovascular risk assessment tools and their guidelines in evaluation of 10-year CVD risk and preventive recommendations: A population based study

BackgroundIdentification of individuals at risk of cardiovascular diseases (CVDs) results in better clinical outcomes and may help policy makers in conscious decision making for community based and national intervention strategies. The main aim of this study was to compare various CVD risk assessment tools and their related guidelines in estimation of 10-year CVD risk and subsequent therapeutic recommendations, respectively. MethodsData of 3086 subjects aged 40–74years from a cohort study of northern Iran were utilized in this cross-sectional study. The risks were calculated based on American College of Cardiology/American Heart Association (ACC/AHA) tool, two versions of Systematic Coronary Risk Evaluation (SCORE) equations (for low and high risk European countries) and Framingham approach. We also detected participants who ought to be recommended for treatment based on the specific guidelines related to each of the risk assessment tools. ResultsMean cardiovascular risks were 12.96%, 8.84%, 1.90% and 3.45% in men and 5.87%, 2.13%, 0.8% and 1.13% in women based on ACC/AHA, Framingham, SCORE equation for low-risk European countries and high-risk European countries, respectively. Based on ACC/AHA, Adult Treatment Panel III (ATPIII) and European Society of Cardiology (ESC) guidelines related to SCORE equations for low and high risk European countries 58.2%, 27.1%, 21.1% and 28.6% of men and 39.7%, 33.0%, 29.5% and 30.7% of women were recommended to statin therapy, respectively. ConclusionsIn conclusion, more individuals were recommended for treatment by ACC/AHA guideline than the other guidelines.

PP.27.21] CLINIC BASED MEASUREMENT OF CENTRAL AORTIC SYSTOLIC PRESSURE – PRACTICAL UTILITY AND ADVANTAGES

Objective: 1. To measure CASP across a cross-section of our patient (pt) population and assess the demographic profile using A-Pulse CASP device. 2. To compare and analyse CASP measurements vs brachial blood pressure (BBP) measurements in pts with Hypertension (HTN) and CKD. Design and method: BBP was measured by oscillometric method using A-Pulse device. CASP was then measured by applanation tonometry and radial transfer function technique by placing the sensor of the A-Pulse CASP device over the ipsilateral radial artery. Results: 90 consecutive pts (males-60;females-30) were included. Subgroups: Group (Gp) A- Normal subjects (n = 25); Gp B – pts with HTN (n = 16); Gp C – pts with CKD, not on dialysis (n = 27) & Gp D –pts with CKD on dialysis (n = 22). In Gp A,mean CASP (114.92 ± 10.8) values across all age gps corresponded to the worldwide reference range. In this gp,subjects (n = 14) with BMI > 25 kg/m2 had significantly higher CASP (119.14 ± 8.66 vs 109 ± 11.21) as compared to subjects (n = 11) with BMI < 25 kg/m2. In Gps B, C & D (n = 65), the mean BASP was 143.09 ± 17.35 and mean CASP was 132.78 ± 16.53 which was higher than the corresponding readings in Gp A. Amongst these pts, the younger sub-gp (n = 29; age < 50 years) had significantly higher CASP (131.76 ± 16.68) comparable with the older sub gp (133.9 ± 16.57) (n = 36; age >50 years) even as the two groups had similar & “within target” BASP readings (142 ± 17.85 vs 144.10 ± 17.02). Mean difference between CASP and BASP was similar in both these subgroups,thus emphasizing that younger pts with HTN & CKD exhibit accelerated vascular ageing <ST>Conclusions:</ST> In healthy individuals,CASP & not BBP, can predict cardiovascular risk much earlier in those with higher BMI. In younger pts with HTN & CKD, Cardiovascular risk is better predicted by CASP and not by BBP measurements. Office based measurement of CASP is a necessary additional tool for thorough cardiovascular risk assessment,especially in pts with CKD.