Identification of Patients at High Cardiovascular Risk

Objective: To identify individuals at high cardiovascular risk (CVR) to check for an additional estimate of CVR with the use of the ESH/ESC Guidelines (2003, 2007) in patients earlier classified as being at low and moderate risk on «SCORE». Material and methods: The study included 600 people (155 men and 445 women) with low and moderate cardiovascular risk on the SCORE scale. All patients were examined with duplex scanning of the carotid arteries (DSCA) to the determined of the thickness of the intima-media (IMT), the presence of atherosclerotic plaques (ASP); it has also been performed sphygmographic computer (SC) with automatic estimation of brachial-ankle pulse wave velocity (baPWV), biochemical analysis of blood lipid spectrum. Results: The frequency of ASP was 59.5% (357 out of 600), and a thickening of the complex "intima-media" (IMT)>0.9 mm was detected in only 5% of the cases (28 persons out of 600), that indicated a slight contribution to the magnitude of the risk of such parameters as the IMT. The total number of patients with signs of preclinical lesions of the arterial wall (the presence of ASP and/or increased baPWV) was 337 (56% of 600). Our results showed that the presence of subclinical atherosclerosis is in itself a risk factor. Conclusion: The usage of instrumental methods of research (DSCA, SC) allowed to detect 32% of individuals with high CVR from 600 previously classified as low and moderate risk on SCORE scale. In our opinion, the proposed algorithm is convenient and easy to use for transfer of the patients into high-risk group.