期刊
AMERICAN JOURNAL OF CARDIOLOGY
卷 121, 期 5, 页码 564-569出版社
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
DOI: 10.1016/j.amjcard.2017.11.031
关键词
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资金
- National Institutes of Health (NIH)/National Heart, Lungs, and Blood Institute (NHLBI), Bethesda, Maryland [1 U01 HL079156-01]
- NIH/NHLBI, Bethesda, Maryland [1 U01 HL79214-01]
- Emory Heart and Vascular Center, Atlanta, Georgia
- NIH from the Clinical and Translational Science Award program, Bethesda, Maryland [UL1 RR025008, R01 HL089650, R01 HL113451]
- American Heart Association Strategically Focused Research Network on Disparities, Dallas, Texas [0000031288]
The pooled cohort Atherosclerotic Cardiovascular Disease (ASCVD) risk calculator is designed to improve cardiovascular risk estimation compared with the Framingham Risk Score, particularly in blacks. Although the ASCVD risk score better predicts mortality and incident cardiovascular disease in blacks, less is known about its performance for subclinical vascular disease measures, including arterial stiffness and carotid intima-media thickness. We sought to determine if the ASCVD risk score better identifies subclinical vascular disease in blacks compared with the Framingham risk score. We calculated both the Framingham and ASCVD cohort risk scores in 1,231 subjects (mean age 53 years, 59% female, 37% black) without known cardiovascular disease and measured the extent of arterial stiffness, as determined by pulse wave velocity (PWV), central pulse pressure (CPP), and central augmentation index (CAIx), and subclinical atherosclerosis, as determined by carotid-IMT (C-IMT). Compared with whites, blacks had higher CAIx (23.9 +/- 10.2 vs 22.1 +/- 9.6%, p = 0.004), CPP (36.4 +/- 10.5 vs 34.9 +/- 9.8 mmHg, p = 0.014), PWV (7.6 +/- 1.5 vs 7.3 +/- 1.3 m/s, p = 0.004), and C-IMT (0.67 +/- 0.10 vs 0.65 +/- 0.10 mm, p = 0.005). In a multivariable analysis including race and Framingham risk score, race remained an independent predictor of all measures of subclinical vascular disease; however, models with race and the ASCVD risk score showed that race was not an independent predictor of subclinical vascular disease. In conclusion, greater subclinical vascular disease in blacks was not estimated by the Framingham risk score. The new ASCVD risk score provided a better estimate of racial differences in vascular function and structure. (C) 2017 Elsevier Inc. All rights reserved.
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