Cardiovascular risk assessment through target organ damage: Role of carotid to femoral pulse wave velocity

1. Cardiovascular risk prediction relies on classical risk factors such as age, gender, lipids, hypertension, smoking and diabetes. Although the value of such scales of risk is high for populations, its value for individuals is reduced and much influenced by non-modifiable risk factors (age and sex). 2. Biomarkers of risk have been deceiving and the genome-wide scan approach is too recent to have been useful. Target-organ damage may help in selecting patients at high risk and determine the necessity of intervention. 3. Aortic pulse wave velocity, an index of aortic stiffness, has been widely validated as providing additional risk prediction above and beyond classical risk factors and has now entered the 2007 guidelines for hypertension of the European Society of Hypertension. 4. We aim to show that individual prediction of cardiovascular-related death can be improved by taking aortic stiffness into account in a cohort of patients during a longitudinal follow-up. 5. Points to be improved are the homogenization and spreading of the technique of measurement, the establishment of a reference value database and the demonstration of the added value of aortic stiffness screening and stratification in interventional trials.