KITAGAWA KAZUO
   Department   Other, Other
   Position  
Article types Original article
Language English
Peer review Peer reviewed
Title Common carotid intima-media thickness measurements do not improve cardiovascular risk prediction in individuals with elevated blood pressure: the USE-IMT collaboration.
Journal Formal name：Hypertension (Dallas, Tex. : 1979)
Abbreviation：Hypertension
ISSN code：(1524-4563)0194-911X(Linking)
Domestic / ForeginForegin
Volume, Issue, Page 63(6),pp.1173-81
Author and coauthor Bots Michiel L, Groenewegen Karlijn A, Anderson Todd J, Britton Annie R, Dekker Jacqueline M, Engström Gunnar, Evans Greg W, de Graaf Jacqueline, Grobbee Diederick E, Hedblad Bo, Hofman Albert, Holewijn Suzanne, Ikeda Ai, Kavousi Maryam, Kitagawa Kazuo, Kitamura Akihiko, Ikram M Arfan, Lonn Eva M, Lorenz Matthias W, Mathiesen Ellisiv B, Nijpels Giel, Okazaki Shuhei, O'Leary Daniel H, Polak Joseph F, Price Jacqueline F, Robertson Christine, Rembold Christopher M, Rosvall Maria, Rundek Tatjana, Salonen Jukka T, Sitzer Matthias, Stehouwer Coen D A, Franco Oscar H, Peters Sanne A E, den Ruijter Hester M
Publication date 2014/06
Summary Carotid intima-media thickness (CIMT) is a marker of cardiovascular risk. It is unclear whether measurement of mean common CIMT improves 10-year risk prediction of first-time myocardial infarction or stroke in individuals with elevated blood pressure. We performed an analysis among individuals with elevated blood pressure (i.e., a systolic blood pressure ≥140 mm Hg and a diastolic blood pressure ≥ 90 mm Hg) in USE-IMT, a large ongoing individual participant data meta-analysis. We refitted the risk factors of the Framingham Risk Score on asymptomatic individuals (baseline model) and expanded this model with mean common CIMT (CIMT model) measurements. From both models, 10-year risks to develop a myocardial infarction or stroke were estimated. In individuals with elevated blood pressure, we compared discrimination and calibration of the 2 models and calculated the net reclassification improvement (NRI). We included 17 254 individuals with elevated blood pressure from 16 studies. During a median follow-up of 9.9 years, 2014 first-time myocardial infarctions or strokes occurred. The C-statistics of the baseline and CIMT models were similar (0.73). NRI with the addition of mean common CIMT was small and not significant (1.4%; 95% confidence intervals, -1.1 to 3.7). In those at intermediate risk (n=5008, 10-year absolute risk of 10% to 20%), the NRI was 5.6% (95% confidence intervals, 1.6-10.4). There is no added value of measurement of mean common CIMT in individuals with elevated blood pressure for improving cardiovascular risk prediction. For those at intermediate risk, the addition of mean common CIMT to an existing cardiovascular risk score is small but statistically significant.
DOI 10.1161/HYPERTENSIONAHA.113.02683
PMID 24614213