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Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration.
Wednesday,2015-03-04 11:58 America/Los_Angeles — zdrager
| Title | Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration. |
| Publication Type | Journal Article |
| Year of Publication | 2014 |
| Authors | Bots, ML, Groenewegen, KA, Anderson, TJ, Britton, AR, Dekker, JM, Engström, G, Evans, GW, de Graaf, J, Grobbee, DE, Hedblad, B, Hofman, A, Holewijn, S, Ikeda, A, Kavousi, M, Kitagawa, K, Kitamura, A, Ikram, AM, Lonn, EM, Lorenz, MW, Mathiesen, EB, Nijpels, G, Okazaki, S, O'Leary, DH, Polak, JF, Price, JF, Robertson, C, Rembold, CM, Rosvall, M, Rundek, T, Salonen, JT, Sitzer, M, Stehouwer, CDA, Franco, OH, Peters, SAE, Ruijter, HM den |
| Journal | Hypertension |
| Volume | 63 |
| Issue | 6 |
| Pagination | 1173-81 |
| Date Published | 2014 Jun |
| ISSN | 1524-4563 |
| Keywords | Adult, Aged, Antihypertensive Agents, Blood Pressure, Cardiovascular Diseases, Carotid Artery, Common, Carotid Intima-Media Thickness, Cohort Studies, Female, Humans, Hypertension, Male, Meta-Analysis as Topic, Middle Aged, Risk Assessment, Risk Factors |
| Abstract | <p>Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (i.e., a systolic blood pressure ≥140 mm Hg and a diastolic blood pressure ≥ 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.</p> |
| DOI | 10.1161/HYPERTENSIONAHA.113.02683 |
| Alternate Journal | Hypertension |
| PubMed ID | 24614213 |
| PubMed Central ID | PMC4523133 |
| Grant List | RG/13/2/30098 / / British Heart Foundation / United Kingdom U01 HL080295 / HL / NHLBI NIH HHS / United States HHSN268200800007C / HL / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States HHSN268201200036C / HL / NHLBI NIH HHS / United States N01HC85082 / HL / NHLBI NIH HHS / United States MR/K013351/1 / / Medical Research Council / United Kingdom PG/11/63/29011 / / British Heart Foundation / United Kingdom N01HC85083 / HL / NHLBI NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States R01 AG023629 / AG / NIA NIH HHS / United States N01HC85080 / HL / NHLBI NIH HHS / United States N01HC85081 / HL / NHLBI NIH HHS / United States |