Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study
Abstract Background Identifying patients at high risk of cardiovascular disease in primary prevention is a challenging task. This study aimed at detecting subclinical atherosclerosis burden in non-diabetic hypertensive patients in a primary care centre. Methods Clinical, anthropometric and analytica...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
BMC
2023-02-01
|
| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-023-01997-8 |
| _version_ | 1811165757559537664 |
|---|---|
| author | José M. Ramírez-Torres Antonio López-Téllez María J. Ariza José Rioja Natalia García-Casares Elena E. González Rodríguez José A. Ramírez García Miguel A. Sánchez Chaparro Miguel A. Barbancho Pedro Valdivielso |
| author_facet | José M. Ramírez-Torres Antonio López-Téllez María J. Ariza José Rioja Natalia García-Casares Elena E. González Rodríguez José A. Ramírez García Miguel A. Sánchez Chaparro Miguel A. Barbancho Pedro Valdivielso |
| author_sort | José M. Ramírez-Torres |
| collection | DOAJ |
| description | Abstract Background Identifying patients at high risk of cardiovascular disease in primary prevention is a challenging task. This study aimed at detecting subclinical atherosclerosis burden in non-diabetic hypertensive patients in a primary care centre. Methods Clinical, anthropometric and analytical data were collected from patients with hypertension who were free from clinical vascular disease and diabetes. The cardiovascular risk was assessed using the SCORE system. Subclinical atherosclerosis burden was assessed by carotid ultrasonography (intima-medial thickness [IMT] and plaque) and measurement of the ankle-brachial index (ABI). Results Out of 140 patients, 59 (42%) have carotid plaque, 32 (23%) have IMT higher than 75% and 12 (9%) have an ABI < 0.9. Total atherosclerosis burden was present in 91 (65%) of the subjects. Consequently, 59 (42%) patients were re-classified into the very high-risk category. In multivariate analyses, smoking, creatinine levels and duration of hypertension were associated with atherosclerosis burden. In contrast, only smoking and age were associated with the presence of carotid plaque. Almost 90% of patients were treated with hypotensive drugs, half of them combined several drugs and 60% were well-controlled. Only 30% received statins in monotherapy and only less than 20% had an LDL cholesterol < 100 mg/dL. Conclusions In non-diabetic hypertensive patients managed at a primary care centre, 4 out of 10 had subclinical atherosclerosis burden and were re-classified into the very high- risk category. There was clear undertreatment with lipid-lowering drugs of most LDL cholesterol inappropriate levels, according to current clinical guidelines. |
| first_indexed | 2024-04-10T15:41:46Z |
| format | Article |
| id | doaj.art-29aaecaaf67e4e53b68b96bf0691ea5f |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-04-10T15:41:46Z |
| publishDate | 2023-02-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-29aaecaaf67e4e53b68b96bf0691ea5f2023-02-12T12:18:39ZengBMCBMC Primary Care2731-45532023-02-012411910.1186/s12875-023-01997-8Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI studyJosé M. Ramírez-Torres0Antonio López-Téllez1María J. Ariza2José Rioja3Natalia García-Casares4Elena E. González Rodríguez5José A. Ramírez García6Miguel A. Sánchez Chaparro7Miguel A. Barbancho8Pedro Valdivielso9Centro de Salud Puerta Blanca, Servicio Andaluz de SaludCentro de Salud Puerta Blanca, Servicio Andaluz de SaludLipids and Atherosclerosis Laboratory, Department of Medicine and Dermatology, Centro de Investigaciones Medico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), University of MálagaLipids and Atherosclerosis Laboratory, Department of Medicine and Dermatology, Centro de Investigaciones Medico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), University of MálagaLipids and Atherosclerosis Laboratory, Department of Medicine and Dermatology, Centro de Investigaciones Medico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), University of MálagaCentro de Salud Puerta Blanca, Servicio Andaluz de SaludCentro de Salud Puerta Blanca, Servicio Andaluz de SaludLipids and Atherosclerosis Laboratory, Department of Medicine and Dermatology, Centro de Investigaciones Medico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), University of MálagaDepartamento de Fisiología Humana, Universidad de MálagaLipids and Atherosclerosis Laboratory, Department of Medicine and Dermatology, Centro de Investigaciones Medico Sanitarias (CIMES), Instituto de Investigación Biomédica de Málaga (IBIMA), University of MálagaAbstract Background Identifying patients at high risk of cardiovascular disease in primary prevention is a challenging task. This study aimed at detecting subclinical atherosclerosis burden in non-diabetic hypertensive patients in a primary care centre. Methods Clinical, anthropometric and analytical data were collected from patients with hypertension who were free from clinical vascular disease and diabetes. The cardiovascular risk was assessed using the SCORE system. Subclinical atherosclerosis burden was assessed by carotid ultrasonography (intima-medial thickness [IMT] and plaque) and measurement of the ankle-brachial index (ABI). Results Out of 140 patients, 59 (42%) have carotid plaque, 32 (23%) have IMT higher than 75% and 12 (9%) have an ABI < 0.9. Total atherosclerosis burden was present in 91 (65%) of the subjects. Consequently, 59 (42%) patients were re-classified into the very high-risk category. In multivariate analyses, smoking, creatinine levels and duration of hypertension were associated with atherosclerosis burden. In contrast, only smoking and age were associated with the presence of carotid plaque. Almost 90% of patients were treated with hypotensive drugs, half of them combined several drugs and 60% were well-controlled. Only 30% received statins in monotherapy and only less than 20% had an LDL cholesterol < 100 mg/dL. Conclusions In non-diabetic hypertensive patients managed at a primary care centre, 4 out of 10 had subclinical atherosclerosis burden and were re-classified into the very high- risk category. There was clear undertreatment with lipid-lowering drugs of most LDL cholesterol inappropriate levels, according to current clinical guidelines.https://doi.org/10.1186/s12875-023-01997-8HypertensionCardiovascular risk assessmentCarotid ultrasonographyAtherosclerotic burdenAnkle-brachial index |
| spellingShingle | José M. Ramírez-Torres Antonio López-Téllez María J. Ariza José Rioja Natalia García-Casares Elena E. González Rodríguez José A. Ramírez García Miguel A. Sánchez Chaparro Miguel A. Barbancho Pedro Valdivielso Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study BMC Primary Care Hypertension Cardiovascular risk assessment Carotid ultrasonography Atherosclerotic burden Ankle-brachial index |
| title | Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study |
| title_full | Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study |
| title_fullStr | Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study |
| title_full_unstemmed | Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study |
| title_short | Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study |
| title_sort | subclinical atherosclerosis burden in non diabetic hypertensives treated in primary care center the imtabi study |
| topic | Hypertension Cardiovascular risk assessment Carotid ultrasonography Atherosclerotic burden Ankle-brachial index |
| url | https://doi.org/10.1186/s12875-023-01997-8 |
| work_keys_str_mv | AT josemramireztorres subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT antoniolopeztellez subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT mariajariza subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT joserioja subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT nataliagarciacasares subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT elenaegonzalezrodriguez subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT josearamirezgarcia subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT miguelasanchezchaparro subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT miguelabarbancho subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy AT pedrovaldivielso subclinicalatherosclerosisburdeninnondiabetichypertensivestreatedinprimarycarecentertheimtabistudy |