RESUMO
Fibromuscular dysplasia (FMD), regarded as a generalized vascular disease, may affect all vascular beds and may result in arterial stenosis, occlusion, aneurysm, or dissection. It has been proposed to systematically evaluate all vascular beds in patients with FMD, regardless of initial FMD involvement. However, the impact of this approach on clinical decisions and on management is unknown. Within the prospective ARCADIA-POL study (Assessment of Renal and Cervical Artery Dysplasia-Poland), we evaluated 232 patients with FMD lesions confirmed in at least one vascular bed, out of 343 patients included in the registry. All patients underwent a detailed clinical evaluation including computed tomography angiography of intracranial and cervical arteries, as well as computed tomography angiography of the abdominal aorta, its branches, and upper and lower extremity arteries. In the study group, FMD lesions were most frequently found in renal arteries (87.5%). FMD was also found in cerebrovascular (24.6%), mesenteric (13.8%), and upper (3.0%) and lower extremity (9.9 %) arteries. Newly diagnosed FMD lesions were found in 34.1% of the patients, and previously undetected vascular complications were found in 25% of the patients. Among all FMD patients included in the study, one out of every 4 evaluated patients qualified for interventional treatment due to newly diagnosed FMD lesions or vascular complications. The ARCADIA-POL study shows for the first time that the systematic and multidisciplinary evaluation of patients with FMD based on a whole-body computed tomography angiography scan has an impact on their clinical management. This proved the necessity of the systematic evaluation of all vascular beds in patients with FMD, regardless of initial FMD involvement.
Assuntos
Aorta Abdominal/diagnóstico por imagem , Artérias Carótidas/diagnóstico por imagem , Artérias Cerebrais/diagnóstico por imagem , Displasia Fibromuscular/diagnóstico por imagem , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Tomada de Decisão Clínica , Angiografia por Tomografia Computadorizada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sistema de Registros , Imagem Corporal Total , Adulto JovemRESUMO
OBJECTIVES: To assess of the levels of neurotic personality dimensions in a group of patients with arterial hypertension compared to healthy individuals. To test the relationship between the overall neurotic personality score and satisfaction with life as well as tendency to notice and attach importance to the positive aspects of life, experience, and oneself in a clinical sample. METHODS: Neurotic Personality Questionnaire (KON-2006) by Aleksandrowicz, Klasa, Sobanski, and Stolarska (2007), Satisfaction With Life Scale (SWLS) by Diener et al., and the P Scale by Caprara (2009). RESULTS: Individuals with arterial hypertension (N =81) are distinguished by significantly higher levels of twenty (out of twenty-four) neurotic personality dimensions than controls without arterial hypertension (N =88). Overall neurotic personality score correlates negatively with life satisfaction and the evaluation of positive aspects of life. CONCLUSIONS: The present study adds to the knowledge on the psychosocial aspects of ill people's functioning and sets directions of work for multidisciplinary teams seeking to improve patients' quality of life.
Assuntos
Hipertensão/psicologia , Transtornos Neuróticos/psicologia , Transtornos da Personalidade/psicologia , Personalidade , Adulto , Feminino , Humanos , Hipertensão/etiologia , Masculino , Pessoa de Meia-Idade , Transtornos Neuróticos/complicações , Transtornos da Personalidade/complicações , Inventário de Personalidade , Qualidade de Vida/psicologia , AutoimagemRESUMO
BACKGROUND: The results of the latest epidemiological studies show that the problem of hyperuricemia affects many millions of people. The main purpose of the study was to assess the knowledge of physicians with regard to the epidemiology and treatment of hyperuricemia in Poland. METHODS: CAPI (computer assisted personal interview) interviews were conducted using short questionnaires among primary health care physicians, cardiologists and diabetologists. The entire questionnaire included 11 questions. Questions were asked to physicians at 5 different periods in time. The number of physicians surveyed, depended on the time period, and ranged from 8663 to 9980. RESULTS: Only every 1 in 7 physicians (14%) considered that hyperuricemia in patients with cardiovascular risk factors begins when the uric acid level is 5 mg/dL, thus in line with the expert recommendations. 72% of respondents asked to indicate the uric acid levels they consider to be indicative of hyperuricemia in patients in the cardiovascular risk group, gave values ranging from 6 to 7 mg/dL, namely the values justified in cases of a patient without such a risk, i.e. in the general population. 86% of doctors surveyed gave values different from that recommended by experts. CONCLUSIONS: The findings of the questionnaire in this survey suggests that doctors often underestimate the problem of hyperuricemia in patients with a high risk of cardiovascular disease. An important step towards more effective therapy of hyperuricemia in routine clinical practice is to raise the awareness of hyperuricemia and its comorbidities both among doctors and patients and encourage monitoring and treatment.
Assuntos
Cardiologistas/psicologia , Endocrinologistas/psicologia , Conhecimentos, Atitudes e Prática em Saúde , Hiperuricemia/epidemiologia , Médicos de Atenção Primária/psicologia , Comorbidade , Feminino , Disparidades em Assistência à Saúde , Humanos , Hiperuricemia/diagnóstico , Hiperuricemia/terapia , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Padrões de Prática Médica , Prognóstico , Medição de Risco , Fatores de RiscoRESUMO
INTRODUCTION Data on the assessment of intrarenal blood flow parameters in patients with renal fibromuscular dysplasia (FMD) are scarce. OBJECTIVES The aim of the study was to evaluate intrarenal blood flow parameters in patients with FMD and significant or nonsignificant renal artery stenosis (RAS). PATIENTS AND METHODS We evaluated intrarenal blood flow parameters by Doppler ultrasonography in 153 patients with renal FMD enrolled in the ARCADIAPOL study: 32 and 121 patients with and without significant RAS, respectively, compared with 60 matched patients with essential hypertension and 60 healthy controls. RESULTS Patients with FMD and significant RAS had a lower renal resistive index (RRI) compared with patients with FMD without significant RAS, patients with essential hypertension, and normotensive controls (mean [SD], 0.51 [0.08] vs 0.60 [0.07], 0.62 [0.06], and 0.61 [0.06], respectively; P <0.001). In patients with nonsignificant RAS, RRI correlated significantly with carotid intima-media thickness, 24hour diastolic blood pressure, 24hour pulse pressure, left ventricular diastolic function, known duration time of hypertension, and age. In patients with significant RAS, there was a significant correlation between RRI and known duration time of hypertension, left ventricular diastolic function, and age. In a separate, "perkidney" analysis, renal arteries with FMD and significant RAS were characterized by lower RRI values, higher maximal blood flow velocity, higher renal aortic ratio, and longer acceleration time compared with renal arteries with FMD and nonsignificant RAS as well as renal arteries without FMD. CONCLUSIONS In contrast to atherosclerotic RAS, intrarenal blood flow in patients with FMD and RAS is preserved, confirming that renal vasculature is relatively intact in these patients.
Assuntos
Displasia Fibromuscular/complicações , Hipertensão Renal/complicações , Rim/fisiopatologia , Obstrução da Artéria Renal/complicações , Resistência Vascular , Adulto , Idoso , Estudos de Casos e Controles , Correlação de Dados , Feminino , Displasia Fibromuscular/fisiopatologia , Humanos , Hipertensão Renal/fisiopatologia , Rim/diagnóstico por imagem , Masculino , Pessoa de Meia-Idade , Polônia , Obstrução da Artéria Renal/fisiopatologia , Circulação Renal , Fatores de Risco , Rigidez VascularRESUMO
The association between fibromuscular dysplasia (FMD) and spontaneous cervical artery dissection (SCeAD) has been recognized, but the available evidence on this relationship is scant. Therefore, the main goal of our study was to systematically evaluate FMD frequency, clinical characteristics and vascular bed involvement in patients with SCeAD. Among 230 patients referred to the ARCADIA-POL study, 43 patients (mean age 44.1 ± 8.9 years; 15 men and 28 women) with SCeAD were referred. Also, 135 patients with FMD were compared to patients with and without SCeAD. Patients underwent: ambulatory blood pressure measurements, biochemical evaluation, echocardiographic examination, and whole body computed tomographic angiography. FMD changes were found in 39.5% of patients with SCeAD. There were no differences in clinical characteristics between patients with SCeAD and FMD and those without FMD, except for a tendency towards a higher female ratio in SCeAD patients with FMD. There were no differences in other parameters describing target organ and SCeAD characteristics. Patients with SCeAD and FMD compared to those without SCeAD were characterized by a lower frequency of hypertension and a higher frequency of hyperlipidemia and history of contraceptive hormone use. Our study indicates a high incidence (39.5%) of FMD in subjects with SCeAD. Since there are no distinctive discriminating factors between patients with SCeAD and FMD and those without FMD, FMD should be suspected in all patients with SCeAD.
Assuntos
Vértebras Cervicais/irrigação sanguínea , Displasia Fibromuscular/epidemiologia , Dissecação da Artéria Vertebral/epidemiologia , Adulto , Monitorização Ambulatorial da Pressão Arterial , Comorbidade , Angiografia por Tomografia Computadorizada , Ecocardiografia , Feminino , Displasia Fibromuscular/diagnóstico , Displasia Fibromuscular/fisiopatologia , Humanos , Hipertensão/diagnóstico , Hipertensão/epidemiologia , Hipertensão/fisiopatologia , Incidência , Masculino , Pessoa de Meia-Idade , Polônia/epidemiologia , Estudos Prospectivos , Fatores de Risco , Fatores Sexuais , Dissecação da Artéria Vertebral/diagnóstico , Dissecação da Artéria Vertebral/fisiopatologia , Imagem Corporal TotalRESUMO
PURPOSE: Smoking was identified as a potential factor contributing to fibromuscular dysplasia (FMD). To evaluate the prevalence of smoking and clinical characteristics in FMD subjects. MATERIAL AND METHODS: We analysed 190 patients with confirmed FMD in at least one vascular bed. The rate of smokers in FMD patients was compared to that in two control groups selected from a nationwide survey. RESULTS: The rate of smokers in FMD patients was 42.6%. There were no differences in frequency of smokers between FMD patients and: a group of 994 matched control subjects from general population and a group of matched hypertensive subjects. There were no differences in the characteristics of FMD (including rates of multisite FMD and significant renal artery stenosis) and its complications (including rates of dissections and aneurysms) between smokers and non-smokers. Smokers as compared with non-smokers were characterized by higher left ventricle mass index. CONCLUSIONS: There is no difference in the rate of smokers between FMD patients and subjects from the general population. Moreover, we did not find any association between smoking and clinical characteristics of FMD patients nor its extent and vascular complications. Our results do not support the hypothesis that smoking is involved in the pathophysiology of FMD.
Assuntos
Displasia Fibromuscular/etiologia , Fumar/efeitos adversos , Aneurisma , Estudos de Casos e Controles , Dissecação/estatística & dados numéricos , Feminino , Displasia Fibromuscular/complicações , Displasia Fibromuscular/epidemiologia , Humanos , Hipertensão , Masculino , Pessoa de Meia-Idade , Prevalência , Sistema de Registros , Obstrução da Artéria Renal/complicações , Fumar/epidemiologiaAssuntos
Doenças Cardiovasculares , Consenso , Hiperuricemia , Ácido Úrico/metabolismo , Doenças Cardiovasculares/diagnóstico , Doenças Cardiovasculares/epidemiologia , Doenças Cardiovasculares/etiologia , Saúde Global , Humanos , Hiperuricemia/complicações , Hiperuricemia/diagnóstico , Hiperuricemia/epidemiologia , Morbidade/tendências , Fatores de RiscoRESUMO
OBJECTIVE: To provide a comprehensive assessment of left ventricle (LV) structure, and function and to detect alterations in cardiac properties in relationship to presence, subtypes and extent of fibromuscular dysplasia (FMD). METHODS: We studied 144 patients with FMD. The control group consisted of 50 matched individuals. Office and ambulatory blood pressure levels were evaluated. Echocardiography was employed to assess: left ventricular mass index (LVMI), systolic function including speckle tracking echocardiography and diastolic function assessed by mitral flow and tissue Doppler imaging. RESULTS: There were no differences in LV morphology and function between patients with FMD and the control group. Among 128 patients with renal FMD, there were no differences in LVMI and LV systolic function between patients with unifocal and multifocal FMD. The patients with multifocal FMD were characterized by lower early diastolic velocity (e') as compared with unifocal FMD and control groups. However, in a multivariate regression model, e' was not independently correlated with FMD. There were no associations between echocardiographic indexes and vascular involvement of FMD. Also, there were no differences in LV morphology and function in patients with significant renal artery stenosis (RAS) compared with patients with history of significant RAS and patients with nonsignificant RAS. CONCLUSION: Our study in contrast to those with atherosclerotic RAS, did not show differences in LV morphology and function between FMD patients and matched controls. Although FMD can result in hypertension and serious vascular complications, there is no proof that it can alter LV regardless of FMD type and its extent.
Assuntos
Ecocardiografia/métodos , Displasia Fibromuscular/diagnóstico por imagem , Ventrículos do Coração/diagnóstico por imagem , Estudos de Casos e Controles , HumanosRESUMO
The reasons for the publication of current expert consensus statement after 4 years from the previous one are: the growing number of evidence on the benefits of the use of single-pill combinations (SPCs) in hypertension (also with concomitant dyslipidaemia), the extension of indications for their use in the hypertension management algorithm and the emergence in recent years after the publication of Polish Society of Hypertension experts' position statement in 2013 of new types of SPCs available to doctors in Poland, including triple-drug combinations of antihypertensives and the so-called "hybrids" SPCs containing not only antihypertensive drugs but also statins. The current position statement of experts summarizes the progress of knowledge and practical application of SPCs of antihy-pertensives in Poland. It seems that there will be a long gap in the introduction of new classes of antihypertensive drugs. The only noticeable progress in the pharmacotherapy of hypertension in the last 15 years, which may explain some increase in the effectiveness of blood pressure control in patients, is more common use of SPCs of antihypertensive drugs. Analysis of European Society of Hypertension (ESH) experts' lectures during this year's ESH 2017 Annual Meeting in Milan suggests that the next edition of the 2018 ESH Guidelines may include major changes in the antihypertensive therapy algorithm, suggesting the need for initiation of pharmacologic treatment with combination therapy, i.e. SPCs, in most patients with hypertension. Combination of an angiotensin converting enzyme (ACE) inhibitor + calcium antagonist should be considered optimal in patients with high and very high cardiovascular risk. Undoubtedly, the position of this combination is due to the ACCOM-PLISH trial in which such SPCs werefound to be more effective in reducing cardiovascular risk than SPCs composed of an ACE-inhibitor + thiazide diuretic. As a result of gradually increasing popularity of combined drugs, further SPCs that meet the criteria for optimal combination of antihypertensive drugs emerged in Poland between 2012 and 2017. Two of them provided the possibility of using SPCs in patients who do not need or should not use renin-angiotensin-aldosterone inhibitors. An interesting alternative is the SPC which contains antihypertensive agents along with other drugs used in cardiovascular prevention: statins and acetylsalicylic acid. This direction in the evolution of pharmacotherapy of hypertension is approaching the concept of "polypill". In the opinion of the authors, the use of SPCs in antihypertensive therapy will increase in Poland, which may contribute to further improvement of pressure control in our country. At present, almost all useful anti-hypertensive agents are available in the form of two-drug SPCs. The combination of a sartan with beta-blocker for hypertensive patients with cardiac hypertrophy who do not tolerate ACE inhibitors and a "hybrid" SPCs of an ACE inhibitor + statin are still expected. Three-drug combinations: ACE inhibitor + beta-blocker + calcium antagonist, for patients with hypertension and coronary artery disease requiring intensive therapy, and ACE inhibitor + beta-blocker + statin, which will enable SPCs therapy for most patients, would also be useful.
Assuntos
Anti-Hipertensivos/uso terapêutico , Consenso , Combinação de Medicamentos , Hipertensão/tratamento farmacológico , Doenças Cardiovasculares/tratamento farmacológico , Gerenciamento Clínico , Humanos , Polônia , Guias de Prática Clínica como Assunto , Sociedades Médicas , ComprimidosRESUMO
Dual energy X-ray absorptiometry (DXA) is an established technique used in clinical and research settings to evaluate total and regional fat. Additionally, recently developed software allow to quantify visceral adipose tissue (VAT). Currently, there are no reference values available for GE Healthcare DXA systems for VAT. The aim of this study was to develop reference values for VAT in healthy European adults aged 20-30 years using a GE Healthcare Prodigy densitometer along with the dedicated CoreScan application. We also assessed the associations of VAT with traditional cardiometabolic risk factors. In 421 participants (207 men; 214 women), we performed DXA whole-body scans and calculated total body fat (BF) and VAT (in gender-specific percentiles). We also measured blood pressure and fasting glucose, insulin, and blood lipids. Males, in comparison with females, had 2-fold greater VAT both in units of mass (542 ± 451 g; 95% CI: 479.6â605.1 g vs. 258 ± 226 g; 95% CI: 226.9â288.6 g) and volume (570 ± 468 cm3; 95% CI: 505.1â635.2 cm3 vs. 273 ± 237 cm3; 95% CI: 240.6â305.3 cm3). They also had significantly higher the VAT/BF ratio. VAT showed a stronger positive correlation than BF with blood pressure, triglycerides, LDL-cholesterol, glucose, insulin, and homeostasis model assessment-insulin resistance index and a stronger negative correlation with HDL-cholesterol. Among these variables, VAT had the highest area under the curve for triglycerides ≥150 mg/dL (0.727 in males and 0.712 in females). In conclusion, we provide reference values for VAT obtained from healthy adults using the GE Healthcare DXA. These values may be useful in the diagnosis of visceral obesity, for identifying subjects with high obesity-related risks, in epidemiological studies, as a target for therapies, and in physically trained individuals. In both genders, VAT was associated with traditional cardiometabolic risk factors, particularly hypertriglyceridemia.
Assuntos
Absorciometria de Fóton/métodos , Gordura Intra-Abdominal/diagnóstico por imagem , Adulto , Europa (Continente) , Feminino , Humanos , Masculino , Polônia , Adulto JovemRESUMO
Excess visceral adipose tissue (VAT) is associated with a cluster of metabolic abnormalities. A new dual-energy X-ray absorptiometry (DXA)-based VAT measurement approach, CoreScan™, computes VAT mass and volume within the android region of a total body DXA scan. However, there have been no reference values developed for this method. The objective of this study was to determine the normal reference ranges for DXA-derived VAT in young, healthy, premenopausal women. We also sought associations between VAT, blood lipids, glucose, insulin and insulin resistance. In 120 randomly selected, normal weight, Caucasian women aged 20-40 years, we measured body fat (BF), VAT and lean mass by DXA. We also assessed blood pressure, waist and hip circumference, waist-to-hip ratio, body mass index, fasting glucose, insulin, triglycerides (TG), and high- (HDL) and low-density lipoproteins. Insulin resistance was evaluated by the homeostasis model assessment (HOMA). VAT mass accounted for 0.37 ± 0.3 % of weight and 1.11 ± 0.72 % of BF. Mean VAT mass and volume were 235.9 ± 183 g (95 % CI 202.7-269.1) and 250.3 ± 194.5 cm(3) (95 % CI 215.1-285.4), respectively. Anthropometric indices moderately correlated with VAT. VAT significantly correlated with HDL (R = -0.193; P = 0.03), glucose (R = 0.252; P = 0.005) and HOMA (R = 0.184; P = 0.049). In this study, we provide normal values of VAT mass and volume measured by DXA and determined for healthy, normal weight, Caucasian women aged 20-40 years. Even in such strictly selected population VAT correlated positively with insulin resistance and inversely with HDL.
Assuntos
Índice de Massa Corporal , Doenças Cardiovasculares/etiologia , Resistência à Insulina/fisiologia , Gordura Intra-Abdominal/diagnóstico por imagem , Adulto , Glicemia/análise , Peso Corporal/fisiologia , Doenças Cardiovasculares/diagnóstico por imagem , Feminino , Humanos , Insulina/sangue , Radiografia , Fatores de Risco , Circunferência da Cintura/fisiologia , Relação Cintura-Quadril , População Branca , Adulto JovemRESUMO
BACKGROUND: The aim of this study was to assess the impact of standard hypoglycaemic treatment strategies on adiponectin levels and fat distribution in patients with newly diagnosed type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: This was a prospective observational study of 50 women with newly diagnosed T2DM, aged 64·6 ± 7·9 years and treated for 12 months with lifestyle modification alone (n = 24) or in combination with metformin (n = 26), according to current standards of diabetic care and clinical practice guidelines. None of the patients required insulin therapy during the entire study period. Total (BF), abdominal (android) and hip (gynoid) fat were measured by dual-energy X-ray absorptiometry at the baseline and after 12 months of treatment. Total adiponectin, glycated haemoglobin (HbA1c) and fasting glucose were measured in 3-month intervals. RESULTS: Baseline adiponectin level was low (9·37 ± 2·81 µg/mL). Lifestyle modifications and metformin produced comparable changes in adiponectin levels, which were not associated with changes in BF, HbA1c, glucose and regional fat depots. Baseline adiponectin was inversely correlated with triglycerides (R = -0·441; P = 0·0007) and the android/gynoid ratio (R = -0·272; P = 0·042). Treatment with metformin was associated with a significant weight reduction (P = 0·033), which resulted from a decrease in BF% (P = 0·044) but was not associated with changes in android and gynoid depots. CONCLUSIONS: In postmenopausal women with newly diagnosed T2DM, lifestyle modifications alone or combined with metformin produced comparable changes in adiponectin levels. Weight reduction in patients treated with metformin was associated with significant decrease in %BF but not in regional fat depots.
Assuntos
Adiponectina/metabolismo , Tecido Adiposo/patologia , Diabetes Mellitus Tipo 2/patologia , Tecido Adiposo/metabolismo , Idoso , Glicemia/metabolismo , Distribuição da Gordura Corporal , Peso Corporal/fisiologia , Diabetes Mellitus Tipo 2/metabolismo , Diabetes Mellitus Tipo 2/terapia , Dieta , Feminino , Hemoglobinas Glicadas/metabolismo , Humanos , Hipoglicemiantes/uso terapêutico , Síndrome Metabólica/metabolismo , Síndrome Metabólica/patologia , Metformina/uso terapêutico , Pessoa de Meia-Idade , Pós-Menopausa , Estudos Prospectivos , Circunferência da Cintura/fisiologiaRESUMO
BACKGROUND: Normal weight obesity (NWO) is defined as percentage body fat (%BF) above 30% or %BF in the upper tertile in normal weight subjects. Using these criteria, we assessed lipid profiles, glucose metabolism parameters, blood pressure and regional fat in 91 premenopausal women with NWO and 54 age-matched healthy controls. METHODS: We measured total cholesterol, high-density lipoproteins (HDL), low-density lipoproteins (LDL), triglycerides (TG), glucose, insulin, visfatin and adiponectin.%BF, abdominal fat (Android) and hip fat (Gynoid) were measured by dual-energy X-ray absorptiometry. Insulin resistance was evaluated by homoeostasis model assessment (HOMA-IR). RESULTS: Women with NWO had higher diastolic blood pressure (DBP) (P = 0·003), LDL (P = 0·048), TG (P = 0·004) Android (P = 0·008) and Gynoid (P = 0·007) levels, but lower HDL (P = 0·009) than healthy controls. The NWO women had one (P = 0·041), two (P = 0·007) or three (P = 0·002) metabolic syndrome components more frequently than the controls. Across %BF tertiles, the number of metabolic syndrome components significantly increased (R = 0·21; P = 0·02), as did Gynoid (R = 0·83; P < 0·001) and Android (R = 0·81; P < 0·001) levels. Android (but not Gynoid) level was linearly associated with DBP (R = 0·194; P = 0·019), HDL (R = -0·295; P = 0·0004) and TG (R = 0·183; P = 0·031). Visfatin and adiponectin levels were comparable in both groups. Visfatin was inversely correlated with cholesterol, LDL and HOMA-IR. Adiponectin was inversely correlated with the Android/Gynoid and Android/Total fat ratios. CONCLUSIONS: Compared with healthy controls, women with NWO had higher DBP, TG, LDL, and regional fat and lower HDL. These findings seem to be associated more with excess Android fat than excess %BF.
Assuntos
Adiponectina/metabolismo , Tecido Adiposo/química , Nicotinamida Fosforribosiltransferase/metabolismo , Obesidade/metabolismo , Pré-Menopausa/metabolismo , Adulto , Antropometria , Peso Corporal , Estudos de Casos e Controles , Feminino , Humanos , Síndrome Metabólica/complicações , Síndrome Metabólica/metabolismo , Obesidade/complicações , Adulto JovemRESUMO
OBJECTIVE. The aim of the present study was to compare the effectiveness of Systemic COronary Risk Evaluation (SCORE) charts and European Society of Hypertension/European Society of Cardiology (ESH/ESC) hypertension guidelines for identifying high-risk hypertensive patients. METHODS. The data on hypertensive patients was collected using the Polish Hypertension Registry. We enrolled 636 patients (357 females and 279 males, mean age 54.4 (+/-) 7.9 years) from hypertension centres in Poland. RESULTS. Only 3.5% of the subjects had no additional risk factors. Thirty-six per cent of the patients had three or more risk factors. Metabolic syndrome was found in 40.1% of the patients. According to the SCORE charts, 9.0% of females and 27.2% of males had high to very high cardiovascular risk (p < 0.001). Taking into account risk factors and the metabolic syndrome, 55.7% of females and 56.3% of males (p = NS) had high or very high additional cardiovascular risk according to the 2007 ESH/ESC guidelines. For both females and males, the prevalence of high to very high risk was greater (p < 0.001) from the calculation based on the 2007 ESH/ESC guidelines than from the SCORE charts. Fifty-two per cent of patients classified as low to moderate risk according to the SCORE system, had high or very high risk according to the 2007 ESH/ESC guidelines. CONCLUSIONS. The SCORE charts seem to underestimate the burden of the cardiovascular risk among hypertensive patients. The cardiovascular risk, especially in the hypertensive female population, seems to be much higher when estimated according to the 2007 ESH/ESC guidelines.