title: Heartscore calculated in individuals younger than 40 years is related to vascular markers of early atherosclerosis.
abstract: BACKGROUND
  Heartscore is not well validated for individuals less than 40 years of age. In the latest guidelines a relative risk chart is provided with the proposal to be used for young adults aged less than 60 years instead of projecting risk at the age of 60 years. Moreover, coronary artery disease is insidiously manifested in younger patients.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Two hundred and two young Greeks of age less than 40 years and 232 middle-aged adults aged 40-60 years without clinically overt cardiovascular disease or diabetes were consecutively recruited. Flow-mediated dilatation of the brachial artery, carotid, and femoral intima media thickness (IMT), carotid-radial and carotid-femoral pulse wave velocity (PWV) were measured in all individuals in one session. The European Society of Cardiology online Heartscore calculator was used for mortality risk (MR) 60 and Systematic Coronary Risk Evaluation risk charts for relative risk (RR) computation.
  
  
  RESULTS
  MR60 in the younger significantly correlated with all measured vascular markers whereas RR significantly correlated with carotid IMT. By multivariate regression analysis, MR60 was a stronger identifier than RR for PWV, mean carotid and femoral IMT in both groups. Young adults (<40 years) with a high MR60 (>5%) had significantly higher carotid-radial PWV, carotid and femoral IMT whereas those with a high RR (>3rd tertile) had significantly higher carotid IMT.
  
  
  CONCLUSIONS
  MR60 was a stronger identifier of most of the measured markers of early atherosclerosis as compared with RR. These data support Heartscore as a prognostic tool in terms of primary prevention for participants younger than 40 years old.
authors.affiliation: Vascular Laboratory, Department of Clinical Therapeutics, Alexandra Hospital, Athens, Greece. stamatelopoulosk@yahoo.gr
authors.forename: Kimon S
authors.initials: KS
authors.lastname: Stamatelopoulos
authors.forename: Christos M
authors.initials: CM
authors.lastname: Papamichael
authors.forename: Achilleas
authors.initials: A
authors.lastname: Zacharoulis
authors.forename: Theodore
authors.initials: T
authors.lastname: Papaioannou
authors.forename: George E
authors.initials: GE
authors.lastname: Kollias
authors.forename: Katerina
authors.initials: K
authors.lastname: Kyrkou
authors.forename: Eleftheria-Elda
authors.initials: EE
authors.lastname: Chrysochoou
authors.forename: Paraskevi
authors.initials: P
authors.lastname: Voidonikola
authors.forename: Maria
authors.initials: M
authors.lastname: Alevizaki
authors.forename: John P
authors.initials: JP
authors.lastname: Lekakis