title: Subclinical arterial wall damage in patients at low to moderate cardiovascular risk.
abstract: OBJECTIVE
  The aim of this paper is to study the degree of subclinical arterial wall damage in subjects at low and moderate risk of cardiovascular death by the SCORE scale using instrumental research methods.
  
  
  METHODS
  We enrolled 600 patients (mean age 49.0 +/- 7.1 years, 74% women) with a calculated SCORE 5%, who passed a carotid duplex ultrasonography with a measurement of the intima-media thickness (IMT) and carotid plaque (CP) severity. In the study a computer sphygmography was also performed on the subjects to determine ankle-brachial pulse wave velocity (abPWV) and an ankle-brachial index (ABI).
  
  
  RESULTS
  We found 389 (64%) patients with subclinical signs of atherosclerosis. CPs were found in 359 patients (60%), thickened IMT in 28 patients (5%), increased abPWV in 227 patients (38%), and ABI of <0.9 in 29 patients (5%). In the patients with a thickened IMT only two had no CPs. In contrast, 92% of the patients with CPs had normal IMT. Increased abPWV was determined in 87% participants with CPs, and only in 30 subjects no CPs were found. All 29 patients with an ABI of less than 0.9 had CPs. The "presence of CP"was the most sensitive parameter in the patients included in the study, in terms of atherosclerosis determination (92%). The identification of individuals with CPs significantly increased in men over 45 years of age (in 68.4% of cases, P = 0.009), and in women over 50 (in 61.8% of cases, P = 0.001).
  
  
  CONCLUSIONS
  Our data reinforces the importance of non-invasive imaging of atherosclerosis in subjects at low and moderate cardiovascular risk. The study demonstrated a high prevalence of subclinical atherosclerosis signs in patients at low to moderate risk by the SCORE scale and a high detection frequency of carotid plaques. This suggests that wider implementation of carotid ultrasound in primary care algorithms may improve risk stratification with timely initiation of preventive strategies.
authors.forename: Sergey A
authors.initials: SA
authors.lastname: Boytcov
authors.forename: Saule J
authors.initials: SJ
authors.lastname: Urazalina
authors.forename: Valeriy V
authors.initials: VV
authors.lastname: Kukharchuk
authors.forename: Tatiana V
authors.initials: TV
authors.lastname: Balakhonova
authors.forename: Igor V
authors.initials: IV
authors.lastname: Sergienko
mesh_terms: D000328:Adult; D055109:Ankle Brachial Index; D001161:Arteriosclerosis / Q000473:pathology*; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000473:pathology; D002339:Carotid Arteries / Q000473:pathology*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058226:Plaque, Atherosclerotic; D018616:Ultrasonography, Doppler, Duplex