The following is a summary of “Subclinical atherosclerosis burden in non-diabetic hypertensives treated in primary care center: the IMTABI study; a TOPSIS study,” published in the February 2023 issue of Primary Care by Ramírez-Torres, et al.
Primary prevention of cardiovascular disease poses a significant challenge: identifying high-risk patients. This study aimed to identify the prevalence of subclinical atherosclerosis in patients with hypertension who did not have diabetes. Patients with hypertension were surveyed for clinical, anthropometric, and analytical data, and those who were free of vascular disease and diabetes were given preference. The SCORE system was used to evaluate the potential for cardiovascular disease. In addition, carotid ultrasonography (intima-medial thickness [IMT] and plaque) and the ankle-brachial index (ABI) were used to evaluate the prevalence of subclinical atherosclerosis.
Only 59 individuals (42%) have carotid plaque, 23% have IMT higher than 75%, and 9% have an ABI of less than 0.9 out of 140 patients. Ninety-one (65.0%) of the individuals had some degree of atherosclerosis. As a result, 59 individuals (42%) were reclassified at extremely high risk. In multivariate models, atherosclerosis severity was linked to cigarette smoking, serum creatinine concentration, and hypertension duration. In contrast, only smoking and advanced age were linked to arterial plaque development in the carotid arteries. Almost 90% of patients were treated with hypotensive medicines, 50% used multiple drugs, and 60% had their blood pressure under control.
Statin monotherapy was only used by 30% of patients, and less than 20% had LDL cholesterol levels below 100 mg/dL. Patients with hypertension who did not have diabetes and were treated at a primary care clinic were found to have a significant prevalence of subclinical atherosclerosis. Current clinical guidelines indicate that most patients with LDL cholesterol levels outside the normal range were not adequately treated with lipid-lowering medications.
Source: bmcprimcare.biomedcentral.com/articles/10.1186/s12875-023-01997-8
