Can we improve cardiovascular risk prediction beyond risk equations in the physician's office?

被引:62
作者
Aboyans, Victor [1 ]
Criqui, Michael H.
机构
[1] Dupuytren Univ, Dept Thorac & Cardiovasc Surg & Angiol, Limoges, France
[2] Univ Calif San Diego, Dept Family & Prevent Med, Div Epidemiol, La Jolla, CA 92093 USA
关键词
blood pressure; heart rate; peripheral arterial disease; prognosis; risk;
D O I
10.1016/j.jclinepi.2005.11.002
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
Background and Objectives: Beyond a global estimation of the cardiovascular risk through the assessment of major risk factors and their integration in dedicated risk scales or equations, the use of specific markers provides additive prognostic information at an individual level, including predisposing factors, which are not included in the risk equations as well as the individual susceptibility to their long-term exposure. However, the majority of these markers require specific devices and skills, which are not widely available in primary care. Methods: Some clinical and/or "low-cost" parameters are shown to be valuable risk markers, and their use could refine the risk estimation in a physician's office. Several epidemiologic studies suggest the heart rate, the pulse pressure and the ankle-brachial index are effective cardiovascular risk markers. The arms systolic pressure asymmetry could also be a useful marker of risk. Results and Conclusions: Through a general review, the authors evaluate the potential of these clinical markers, including their use in combination for more accurate risk determination. (C) 2006 Elsevier Inc. All rights reserved.
引用
收藏
页码:547 / 558
页数:12
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