In:
Journal of Hypertension, Ovid Technologies (Wolters Kluwer Health), Vol. 40, No. 8 ( 2022-08), p. 1469-1477
Abstract:
We aimed to study the relationship between cerebral small vessel disease (cSVD) lesions, as markers of subclinical target organ damage (TOD) in the brain, and incident cardiovascular events (CVE). Methods: Data from the ISSYS (Investigating Silent Strokes in hYpertensives Study), which is a longitudinal and observational study conducted in patients with hypertension aged 50–70 years, and stroke-free at the inclusion. At the baseline visit, participants underwent a clinical interview, a brain MRI, urine and blood sampling collection and vascular testing studies. Therefore, we obtained markers of TOD from the brain [white matter hyperintensities, silent brain infarcts (SBI), cerebral microbleeds and enlarged perivascular spaces (EPVS)], from kidney (microalbuminuria, glomerular filtration) and regarding large vessels [ankle-to-brachial index (ABI), carotid–femoral pulse wave velocity] . Survival analyses were used to assess the relationship between these predictors and the incidence of cardiovascular events (CVE). Results: We followed-up 964 individuals within a median time of 5 years (4.7–5), representing 4377.1 persons-year. We found 73 patients presenting incident CVE, which corresponds to a rate of 8.2%. We found ABI less than 0.9 [hazard ratio, 2.2; 95% confidence interval (CI) 1.17–4.13, P value = 0.014] and SBI (hazard ratio, 2.9; 95% CI 1.47–5.58, P value = 0.002) independently associated with higher risk of incident CVE. The inclusion of both variables in a clinical model resulted in an increased discrimination of individuals with new CVE of 4.72%, according to the integrated discrimination index. Conclusion: Assessment of SBI and ABI less than 0.9 may refine the cardiovascular risk stratification in patients with hypertension.
Type of Medium:
Online Resource
ISSN:
0263-6352
,
1473-5598
DOI:
10.1097/HJH.0000000000003154
Language:
English
Publisher:
Ovid Technologies (Wolters Kluwer Health)
Publication Date:
2022
detail.hit.zdb_id:
2017684-3
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