title: The assessment of total cardiovascular risk in hypertensive subjects in primary care.
abstract: BACKGROUND
  Recently published guidelines emphasize that detection of any subclinical target organ damage in hypertensive subjects should be regarded as a sign of high cardiovascular risk.
  
  
  OBJECTIVE
  To assess the ability of conventional multivariable cardiovascular disease risk prediction tools and high-sensitivity C-reactive protein (hs-CRP) to identify hypertensive subjects with target organ damage.
  
  
  METHODS
  Ankle-brachial index (ABI), estimated glomerular filtration rate (eGFR), electrocardiographically determined left ventricular hypertrophy (ECG-LVH), and base-line variables were measured in hypertensive subjects aged 45-70 years without established cardiovascular or renal disease or known diabetes.
  
  
  RESULTS
  Of the 495 subjects, 123 (24.8% (95% CI 21.1-28.9)) had ABI <1.00, 81 (16.4% (95% CI 13.2-19.9)) had ECG-LVH, and 41 (8.3% (95% CI 6.0-11.1)) had eGFR <60 mL/min/1.73 m(2). In patients with SCORE <5% or Framingham risk <20%, any sign of target organ damage was found in 46% and 49% of patients, respectively.
  
  
  CONCLUSIONS
  Assessment of ECG-LVH, ABI, and eGFR reclassifies a significant number of hypertensive patients to the high-risk category as compared to SCORE and Framingham risk prediction tools only.
authors.affiliation: Central Satakunta Health Federation of Municipalities, Harjavalta, Finland. paivi.e.korhonen@fimnet.fi
authors.forename: Päivi E
authors.initials: PE
authors.lastname: Korhonen
authors.forename: Risto K
authors.initials: RK
authors.lastname: Vesalainen
authors.forename: Pertti T
authors.initials: PT
authors.lastname: Aarnio
authors.forename: Tarja
authors.initials: T
authors.lastname: Saaresranta
authors.forename: Hannu
authors.initials: H
authors.lastname: Kautiainen
authors.forename: Salme
authors.initials: S
authors.lastname: Järvenpää
authors.forename: Ilkka M
authors.initials: IM
authors.lastname: Kantola
mesh_terms: D000368:Aged; D019540:Area Under Curve; D002097:C-Reactive Protein / Q000032:analysis; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D005260:Female; D005919:Glomerular Filtration Rate; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000503:physiopathology; D017379:Hypertrophy, Left Ventricular / Q000175:diagnosis / Q000209:etiology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011320:Primary Health Care; D012107:Research Design; D012307:Risk Factors
chemical_list: D002097:C-Reactive Protein