Resumo: Introdução e objetivos: Embora a medida da espessura íntimo-medial carotídea (EIMC) seja considerada um marcador direto de aterosclerose subclínica, com importante valor potencial na ...estratificação de risco cardiovascular, a mesma não tem sido preconizada para uso rotineiro em indivíduos hipertensos. O presente estudo se propôs a investigar a prevalência de aterosclerose subclínica, avaliada pela medida da EIMC, e o impacto desta na estratificação de risco do paciente hipertenso. Métodos: Trata-se de estudo transversal que incluiu 94 hipertensos sem doença aterosclerótica manifesta, com média de idade de 56,99 ± 11,89 anos, sendo 68,1% do sexo feminino, submetidos a exame clínico, dosagens bioquímicas, ecodopplercardiograma e medida da EIMC por ultrassonografia de alta resolução. Resultados: Apesar de a maioria dos indivíduos ter sido estratificada como de risco baixo (63,5%) e intermediário (23%), segundo o escore de Framingham (EF), observou-se expressiva prevalência de espessamento carotídeo na amostra (75,3%), inclusive nos subgrupos de risco baixo (61%) e intermediário (93,8%). A EIMC concorreu para a reclassificação de risco em 70,31% dos pacientes em geral, sendo que 61% dos de risco baixo passaram para o intermediário e 93,8% dos de risco intermediário para o alto. Conclusão: Nestes indivíduos hipertensos ambulatoriais, predominantemente de meia-idade e do sexo feminino, a medida da EIMC demonstrou elevada prevalência de aterosclerose subclínica bem como concorreu para a reclassificação de risco em expressiva proporção dos casos. Abstract: Introduction and Objectives: Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. The aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients. Methods: This was a cross-sectional study of 94 middle-aged (56.99±11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound. Results: Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk. Conclusion: In these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases. Palavras-chave: Hipertensão, Espessura íntimo-medial carotídea, Estratificação de risco, Keywords: Hypertension, Carotid intima-media thickness, Risk assessment
Embora a medida da espessura íntimo-medial carotídea (EIMC) seja considerada um marcador direto de aterosclerose subclínica, com importante valor potencial na estratificação de risco cardiovascular, ...a mesma não tem sido preconizada para uso rotineiro em indivíduos hipertensos. O presente estudo se propôs a investigar a prevalência de aterosclerose subclínica, avaliada pela medida da EIMC, e o impacto desta na estratificação de risco do paciente hipertenso.
Trata-se de estudo transversal que incluiu 94 hipertensos sem doença aterosclerótica manifesta, com média de idade de 56,99±11,89 anos, sendo 68,1% do sexo feminino, submetidos a exame clínico, dosagens bioquímicas, ecodopplercardiograma e medida da EIMC por ultrassonografia de alta resolução.
Apesar de a maioria dos indivíduos ter sido estratificada como de risco baixo (63,5%) e intermediário (23%), segundo o escore de Framingham (EF), observou-se expressiva prevalência de espessamento carotídeo na amostra (75,3%), inclusive nos subgrupos de risco baixo (61%) e intermediário (93,8%). A EIMC concorreu para a reclassificação de risco em 70,31% dos pacientes em geral, sendo que 61% dos de risco baixo passaram para o intermediário e 93,8% dos de risco intermediário para o alto.
Nestes indivíduos hipertensos ambulatoriais, predominantemente de meia-idade e do sexo feminino, a medida da EIMC demonstrou elevada prevalência de aterosclerose subclínica bem como concorreu para a reclassificação de risco em expressiva proporção dos casos.
Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its routine use in hypertensive patients is not recommended. The aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients.
This was a cross-sectional study of 94 middle-aged (56.99±11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound.
Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk.
In these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases.
Abstract Introduction and objectives Although carotid intima-media thickness (CIMT) is considered a surrogate marker of subclinical atherosclerosis, with known value in risk stratification, its ...routine use in hypertensive patients is not recommended. The aim of this study was to determine the prevalence of subclinical atherosclerosis through measurement of CIMT and its impact on reclassification of risk in hypertensive patients. Methods This was a cross-sectional study of 94 middle-aged (56.99±11.89 years) hypertensive outpatients without overt cardiovascular disease, 68.1% female. All participants underwent clinical examination, biochemical tests, echocardiogram and measurement of CIMT by high-resolution ultrasound. Results Although the majority of patients were stratified as low (63.5%) or intermediate risk (23%) according to their Framingham score, a high prevalence (75.3%) of increased CIMT was observed in the overall sample, including in the low (61%) and intermediate risk groups (93.8%). CIMT measurement resulted in risk reclassification of 70.31% of the patients, 61% of those at low risk being reclassified as intermediate risk and 93.8% of those at intermediate risk being reclassified as high risk. Conclusion In these hypertensive outpatients, predominantly middle-aged and female, CIMT measurement revealed a high prevalence of subclinical atherosclerosis and resulted in risk reclassification in the majority of cases.
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