title: Early detection of subjects at risk for vascular remodelling - results from the Swiss population-based study SAPALDIA.
abstract: OBJECTIVE
  As the burden of cardiovascular disease (CVD) increases globally, its prevention and risk assessment becomes ever more important. We thus investigated the longitudinal association of the cardiovascular risk scores in the population-based cohort SAPALDIA with carotid intima media thickening (CIMT), an indicator of sub-clinical disease, and CVD incidence.
  
  
  METHODS
  In 2,832 SAPALDIA participants, the Swiss and ESC heart risk score (AGLA, SCORE) were calculated based on 2001 data and CIMT was measured in 2010/11. We ran multi-level linear regression analyses between scores and CIMT, stratified for CVD status and gender, and logistic analyses for doctor-diagnosed CVD incidence. Path analyses investigated direct and indirect effects on CIMT.
  
  
  RESULTS
  AGLA and SCORE were positively associated with increasing CIMT in both healthy and CVD diagnosed subjects and men and women. Participants in highest risk categories showed a significant CIMT difference of >0.20 mm compared to the reference risk category (<1%), even larger in CVD healthy subjects and men. With increasing risk the odds of CVD incidence increased (Ref. <1%; 10 yr. risk AGLA >10% OR 2.1, >20% OR 3.7). Path analyses yield risk factors' direct and indirect effects through blood pressure.
  
  
  CONCLUSIONS
  The positive longitudinal association between risk estimations and CIMT confirms the use of risk scores in assessing individuals and populations at risk. Systolic blood pressure appears to be a main pathological mechanism, underscoring the importance of optimal blood pressure control and the importance of prevention strategies of risk factors, indirectly affecting CIMT through the haemodynamic pathway.
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Switzerland.
authors.forename: Julia
authors.initials: J
authors.lastname: Dratva
authors.affiliation: Department of Sport, Exercise and Health, Div. Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Basel, Switzerland.
authors.forename: Seraina
authors.initials: S
authors.lastname: Caviezel
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Switzerland.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Schaffner
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Switzerland.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Zemp
authors.affiliation: Imagelabonline and Cardiovascular, Science Park 400, Matrix II, Amsterdam and the Department of Cardiology and Thoracic Surgery, Academic Medical Centre, Meibergdreef 9, Amsterdam, NL.
authors.forename: Eric
authors.initials: E
authors.lastname: de Groot
authors.affiliation: Department of Sport, Exercise and Health, Div. Sports and Exercise Medicine, University of Basel, St. Jakob-Arena, Basel, Switzerland.
authors.forename: Arno
authors.initials: A
authors.lastname: Schmidt-Trucksäss
authors.affiliation: Imagelabonline and Cardiovascular, Science Park 400, Matrix II, Amsterdam and the Department of Cardiology and Thoracic Surgery, Academic Medical Centre, Meibergdreef 9, Amsterdam, NL.
authors.forename: Robert
authors.initials: R
authors.lastname: Bettschart
authors.affiliation: Universität Zürich, Institut für Klinische Chemie, Zürich, Switzerland.
authors.forename: Lanja
authors.initials: L
authors.lastname: Saleh
authors.affiliation: Zürcher Höhenklinik, Wald-Faltigberg, Faltigberg-Wald, Switzerland.
authors.forename: Alexander
authors.initials: A
authors.lastname: Turk
authors.affiliation: Hôpitaux Universitaires de Genève, Policlinique, Genève, Switzerland.
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Gaspoz
authors.affiliation: Hôpitaux Universitaires de Genève, Division of Cardiology, Genève, Switzerland.
authors.forename: David
authors.initials: D
authors.lastname: Carballo
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Switzerland.
authors.forename: Nino
authors.initials: N
authors.lastname: Kuenzli
authors.affiliation: Swiss Tropical and Public Health Institute, Basel, Switzerland, and University of Basel, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Probst-Hensch
mesh_terms: D000328:Adult; D000368:Aged; D015415:Biomarkers; D001794:Blood Pressure; D001837:Body Weights and Measures; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D059168:Carotid Intima-Media Thickness / Q000706:statistics & numerical data*; D015331:Cohort Studies; D042241:Early Diagnosis; D005260:Female; D015438:Health Behavior; D006801:Humans; D015994:Incidence; D008019:Life Style; D008055:Lipids / Q000097:blood; D008297:Male; D008875:Middle Aged; D017698:Postmenopause; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000453:epidemiology; D012959:Socioeconomic Factors; D013557:Switzerland / Q000453:epidemiology; D066253:Vascular Remodeling
chemical_list: D015415:Biomarkers; D008055:Lipids