Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: A role for organ damage markers

Massimo Volpe, Allegra Battistoni, Giuliano Tocci, Enrico Agabiti Rosei, Alberico L. Catapano, Rosanna Coppo, Stefano Del Prato, Sandro Gentile, Elmo Mannarino, Salvatore Novo, Domenico Prisco, Giuseppe Mancia

Research output: Contribution to journalArticle

Abstract

Background: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. Objective: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with the purpose to ameliorate individual risk assessment. Methodology: We searched www.Pubmed.gov for evidence about the predictive value of left ventricular hypertrophy (LVH), estimated glomerular filtration rate (eGFR), microalbuminuria (MAU) and metabolic syndrome on different risk profiles estimated by SCORE. Interventional and observational trials including at least 200 patients and published after 2000 were selected. Results: The presence of organ damage as well as the number of abnormal parameters indicating organ damage is associated with increased cardiovascular risk, independently of SCORE. In the area of high risk, the impact of different markers of organ damage is heterogeneous. Combined risk models of SCORE and subclinical organ damage have major impact on risk stratification and may impact on recommendation in primary prevention in all SCORE categories. Conclusion: Available evidence suggests a tangible clinical advantage of adding the evaluation of simple organ damage markers to risk charts in cardiovascular risk prediction.

Original languageEnglish
Pages (from-to)1056-1064
Number of pages9
JournalJournal of Hypertension
Volume30
Issue number6
DOIs
Publication statusPublished - Jun 2012

Fingerprint

Left Ventricular Hypertrophy
Primary Prevention
Glomerular Filtration Rate
PubMed

Keywords

  • cardiovascular risk
  • estimated glomerular filtration rate
  • left ventricular hypertrophy
  • metabolic syndrome
  • microalbuminuria
  • prevention
  • SCORE
  • target organ damage

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation : A role for organ damage markers. / Volpe, Massimo; Battistoni, Allegra; Tocci, Giuliano; Rosei, Enrico Agabiti; Catapano, Alberico L.; Coppo, Rosanna; Del Prato, Stefano; Gentile, Sandro; Mannarino, Elmo; Novo, Salvatore; Prisco, Domenico; Mancia, Giuseppe.

In: Journal of Hypertension, Vol. 30, No. 6, 06.2012, p. 1056-1064.

Research output: Contribution to journalArticle

Volpe, M, Battistoni, A, Tocci, G, Rosei, EA, Catapano, AL, Coppo, R, Del Prato, S, Gentile, S, Mannarino, E, Novo, S, Prisco, D & Mancia, G 2012, 'Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: A role for organ damage markers', Journal of Hypertension, vol. 30, no. 6, pp. 1056-1064. https://doi.org/10.1097/HJH.0b013e3283525715
Volpe, Massimo ; Battistoni, Allegra ; Tocci, Giuliano ; Rosei, Enrico Agabiti ; Catapano, Alberico L. ; Coppo, Rosanna ; Del Prato, Stefano ; Gentile, Sandro ; Mannarino, Elmo ; Novo, Salvatore ; Prisco, Domenico ; Mancia, Giuseppe. / Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation : A role for organ damage markers. In: Journal of Hypertension. 2012 ; Vol. 30, No. 6. pp. 1056-1064.
@article{8608fade3a114b4c9f8052c66281ec1d,
title = "Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation: A role for organ damage markers",
abstract = "Background: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. Objective: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with the purpose to ameliorate individual risk assessment. Methodology: We searched www.Pubmed.gov for evidence about the predictive value of left ventricular hypertrophy (LVH), estimated glomerular filtration rate (eGFR), microalbuminuria (MAU) and metabolic syndrome on different risk profiles estimated by SCORE. Interventional and observational trials including at least 200 patients and published after 2000 were selected. Results: The presence of organ damage as well as the number of abnormal parameters indicating organ damage is associated with increased cardiovascular risk, independently of SCORE. In the area of high risk, the impact of different markers of organ damage is heterogeneous. Combined risk models of SCORE and subclinical organ damage have major impact on risk stratification and may impact on recommendation in primary prevention in all SCORE categories. Conclusion: Available evidence suggests a tangible clinical advantage of adding the evaluation of simple organ damage markers to risk charts in cardiovascular risk prediction.",
keywords = "cardiovascular risk, estimated glomerular filtration rate, left ventricular hypertrophy, metabolic syndrome, microalbuminuria, prevention, SCORE, target organ damage",
author = "Massimo Volpe and Allegra Battistoni and Giuliano Tocci and Rosei, {Enrico Agabiti} and Catapano, {Alberico L.} and Rosanna Coppo and {Del Prato}, Stefano and Sandro Gentile and Elmo Mannarino and Salvatore Novo and Domenico Prisco and Giuseppe Mancia",
year = "2012",
month = "6",
doi = "10.1097/HJH.0b013e3283525715",
language = "English",
volume = "30",
pages = "1056--1064",
journal = "Journal of Hypertension",
issn = "0263-6352",
publisher = "Lippincott Williams and Wilkins",
number = "6",

}

TY - JOUR

T1 - Cardiovascular risk assessment beyond Systemic Coronary Risk Estimation

T2 - A role for organ damage markers

AU - Volpe, Massimo

AU - Battistoni, Allegra

AU - Tocci, Giuliano

AU - Rosei, Enrico Agabiti

AU - Catapano, Alberico L.

AU - Coppo, Rosanna

AU - Del Prato, Stefano

AU - Gentile, Sandro

AU - Mannarino, Elmo

AU - Novo, Salvatore

AU - Prisco, Domenico

AU - Mancia, Giuseppe

PY - 2012/6

Y1 - 2012/6

N2 - Background: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. Objective: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with the purpose to ameliorate individual risk assessment. Methodology: We searched www.Pubmed.gov for evidence about the predictive value of left ventricular hypertrophy (LVH), estimated glomerular filtration rate (eGFR), microalbuminuria (MAU) and metabolic syndrome on different risk profiles estimated by SCORE. Interventional and observational trials including at least 200 patients and published after 2000 were selected. Results: The presence of organ damage as well as the number of abnormal parameters indicating organ damage is associated with increased cardiovascular risk, independently of SCORE. In the area of high risk, the impact of different markers of organ damage is heterogeneous. Combined risk models of SCORE and subclinical organ damage have major impact on risk stratification and may impact on recommendation in primary prevention in all SCORE categories. Conclusion: Available evidence suggests a tangible clinical advantage of adding the evaluation of simple organ damage markers to risk charts in cardiovascular risk prediction.

AB - Background: Cardiovascular risk assessment in the clinical practice is mostly based on risk charts, such as Framingham risk score and Systemic Coronary Risk Estimation (SCORE). These enable clinicians to estimate the impact of cardiovascular risk factors and assess individual cardiovascular risk profile. Risk charts, however, do not take into account subclinical organ damage, which exerts independent influence on risk and may amplify the estimated risk profile. Inclusion of organ damage markers in the assessment may thus contribute to improve this process. Objective: Our aim was to evaluate the influence of implementation of SCORE charts with widely available indexes of organ damage, with the purpose to ameliorate individual risk assessment. Methodology: We searched www.Pubmed.gov for evidence about the predictive value of left ventricular hypertrophy (LVH), estimated glomerular filtration rate (eGFR), microalbuminuria (MAU) and metabolic syndrome on different risk profiles estimated by SCORE. Interventional and observational trials including at least 200 patients and published after 2000 were selected. Results: The presence of organ damage as well as the number of abnormal parameters indicating organ damage is associated with increased cardiovascular risk, independently of SCORE. In the area of high risk, the impact of different markers of organ damage is heterogeneous. Combined risk models of SCORE and subclinical organ damage have major impact on risk stratification and may impact on recommendation in primary prevention in all SCORE categories. Conclusion: Available evidence suggests a tangible clinical advantage of adding the evaluation of simple organ damage markers to risk charts in cardiovascular risk prediction.

KW - cardiovascular risk

KW - estimated glomerular filtration rate

KW - left ventricular hypertrophy

KW - metabolic syndrome

KW - microalbuminuria

KW - prevention

KW - SCORE

KW - target organ damage

UR - http://www.scopus.com/inward/record.url?scp=84861056940&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84861056940&partnerID=8YFLogxK

U2 - 10.1097/HJH.0b013e3283525715

DO - 10.1097/HJH.0b013e3283525715

M3 - Article

C2 - 22573072

AN - SCOPUS:84861056940

VL - 30

SP - 1056

EP - 1064

JO - Journal of Hypertension

JF - Journal of Hypertension

SN - 0263-6352

IS - 6

ER -