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Role of echocardiography and carotid ultrasonography in stratifying risk in patients with essential hypertension
CUSPIDI C; AMBROSIONI E; MANCIA G
J HYPERTENS , 2002, vol. 20, n° 7, p. 1307-1314 Doc n°: 107051 Localisation : Documentation IRR Descripteurs : FB311 - HYPERTENSION ARTERIELLE Echocardiography and carotid ultrasonography, by providing a more accurate assessment of cardiac and vascular damage related to hypertension, may lead to a more precise stratification of the global cardiovascular risk. However, current guidelines do not recommend systematic use of ultrasound examination of heart and large arteries in evaluating the cardiovascular risk in patients with hypertension. Objective To assess the impact of echocardiography and carotid ultrasonography on global risk stratification in hypertensive patients classified as being at low or medium risk according to routine clinical work-up as suggested by current hypertension guidelines. Methods Among 8502 consecutive patients screened at 44 outpatient hypertension hospital clinics in different parts of Italy, 1074 untreated individuals with low-to-medium risk essential hypertension were identified on the basis of the diagnostic routine procedures suggested by 1999 World Health Organization/International Society of Hypertension guidelines: medical history, physical examination and clinic blood pressure measurement; routine blood chemistry and urine analysis; electrocardiogram. The extent of risk for the 1074 individuals was reassessed by adding the results of ultrasound examinations of heart and carotid arteries: left ventricular hypertrophy (defined as left ventricular mass index > 120 g/m(2) in men and > 100 g/m(2) in women), carotid intima-media thickening (defined as diffuse thickening if greater than or equal to 0.8 mm), and presence of plaque (defined as focal thickening > 1.3 mm). Results According to routine classification, 18.7% (n = 201) of the 1074 patients were considered at low risk and 81.3% (n = 873) at medium risk. Langue : ANGLAIS Tiré à part : OUI Identifiant basis : 2003225132 |
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