OBJECTIVE: To investigate the impact and cost-effectiveness of carotid ultrasonographic examination on total risk stratification in low-medium risk hypertensive patients in relation to age (< 50 and > 50 years) and gender. METHODS: Five hundred and eighty untreated hypertensives classified at low-medium risk, after the routine work-up recommended by the 2003 ESH/ ESC guidelines, were included in the study and total risk was reassessed by adding the results of carotid ultrasonography. RESULTS: According to the stratification based on routine work-up 16.3% of the whole population was considered at low added risk and 83.7% at medium added risk. Carotid subclinical damage was found in 158 patients (27.0%), who were then reclassified in the high-risk stratum. Prevalence rates of patients reclassified in the high-risk stratum as a consequence of carotid damage were as follows: 12.6% in men < 50 years, 14.1% in women < 50 years, 53.0% in men > or = 50 years and 40.1% in women > or = 50 years. The cost per detected case of carotid atherosclerosis was 473 euro in patients < 50 years and 133 euro in those > or = 50 years. CONCLUSIONS: Our results show that: (i) the use of carotid ultrasonography allows a much more accurate identification of high-risk individuals; (ii) its impact and cost-effectiveness on the risk stratification process differs markedly according to the age and gender; (iii) the selective use of this procedure in subjects at high risk of target organ damage may substantially improve the cost of primary prevention.

Cuspidi, C., Meani, S., Valerio, C., Fusi, V., Sala, C., Zanchetti, A., et al. (2006). Carotid atherosclerosis and cardiovascular risk stratification: role and cost-effectiveness of echo-Doppler examination in untreated essential hypertensives. BLOOD PRESSURE, 15(6), 333-339 [10.1080/08037050601066553].

Carotid atherosclerosis and cardiovascular risk stratification: role and cost-effectiveness of echo-Doppler examination in untreated essential hypertensives

CUSPIDI, CESARE;MANCIA, GIUSEPPE
2006

Abstract

OBJECTIVE: To investigate the impact and cost-effectiveness of carotid ultrasonographic examination on total risk stratification in low-medium risk hypertensive patients in relation to age (< 50 and > 50 years) and gender. METHODS: Five hundred and eighty untreated hypertensives classified at low-medium risk, after the routine work-up recommended by the 2003 ESH/ ESC guidelines, were included in the study and total risk was reassessed by adding the results of carotid ultrasonography. RESULTS: According to the stratification based on routine work-up 16.3% of the whole population was considered at low added risk and 83.7% at medium added risk. Carotid subclinical damage was found in 158 patients (27.0%), who were then reclassified in the high-risk stratum. Prevalence rates of patients reclassified in the high-risk stratum as a consequence of carotid damage were as follows: 12.6% in men < 50 years, 14.1% in women < 50 years, 53.0% in men > or = 50 years and 40.1% in women > or = 50 years. The cost per detected case of carotid atherosclerosis was 473 euro in patients < 50 years and 133 euro in those > or = 50 years. CONCLUSIONS: Our results show that: (i) the use of carotid ultrasonography allows a much more accurate identification of high-risk individuals; (ii) its impact and cost-effectiveness on the risk stratification process differs markedly according to the age and gender; (iii) the selective use of this procedure in subjects at high risk of target organ damage may substantially improve the cost of primary prevention.
Articolo in rivista - Articolo scientifico
atherosclerosis, echoDoppler, hypertension, organ damage
English
333
339
Cuspidi, C., Meani, S., Valerio, C., Fusi, V., Sala, C., Zanchetti, A., et al. (2006). Carotid atherosclerosis and cardiovascular risk stratification: role and cost-effectiveness of echo-Doppler examination in untreated essential hypertensives. BLOOD PRESSURE, 15(6), 333-339 [10.1080/08037050601066553].
Cuspidi, C; Meani, S; Valerio, C; Fusi, V; Sala, C; Zanchetti, A; Mancia, G
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10281/4719
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