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Common Carotid Intima-Media Thickness Measurements Do Not Improve Cardiovascular Risk Prediction in Individuals With Elevated Blood Pressure The USE-IMT Collaboration

Bots, Michiel L.; Groenewegen, Karlijn A.; Anderson, Todd J.; Britton, Annie R.; Dekker, Jacqueline M.; Engström, Gunnar LU ; Evans, Greg W.; de Graaf, Jacqueline; Grobbee, Diederick E. and Hedblad, Bo LU , et al. (2014) In Hypertension 63(6). p.1173-1181
Abstract
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 (ie, 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... (More)
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 (ie, 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. (Less)
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Contribution to journal
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published
subject
keywords
atherosclerosis, carotid intima-media thickness, primary prevention, prognosis, risk
in
Hypertension
volume
63
issue
6
pages
1173 - 1181
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000335491900151
  • scopus:84902268214
ISSN
1524-4563
DOI
10.1161/HYPERTENSIONAHA.113.02683
language
English
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yes
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87b40b2e-3252-4a81-a75f-0313d435e06e (old id 4558951)
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2014-08-01 07:41:27
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2017-10-08 03:20:56
@article{87b40b2e-3252-4a81-a75f-0313d435e06e,
  abstract     = {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 (ie, 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.},
  author       = {Bots, Michiel L. and Groenewegen, Karlijn A. and Anderson, Todd J. and Britton, Annie R. and Dekker, Jacqueline M. and Engström, Gunnar and Evans, Greg W. and de Graaf, Jacqueline and Grobbee, Diederick E. and Hedblad, Bo and Hofman, Albert and Holewijn, Suzanne and Ikeda, Ai and Kavousi, Maryam and Kitagawa, Kazuo and Kitamura, Akihiko and Ikram, M. Arfan and Lonn, Eva M. and Lorenz, Matthias W. and Mathiesen, Ellisiv B. and Nijpels, Giel and Okazaki, Shuhei and O'Leary, Daniel H. and Polak, Joseph F. and Price, Jacqueline F. and Robertson, Christine and Rembold, Christopher M. and Rosvall, Maria and Rundek, Tatjana and Salonen, Jukka T. and Sitzer, Matthias and Stehouwer, Coen D. A. and Franco, Oscar H. and Peters, Sanne A. E. and den Ruijter, Hester M.},
  issn         = {1524-4563},
  keyword      = {atherosclerosis,carotid intima-media thickness,primary prevention,prognosis,risk},
  language     = {eng},
  number       = {6},
  pages        = {1173--1181},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Hypertension},
  title        = {Common Carotid Intima-Media Thickness Measurements Do Not Improve Cardiovascular Risk Prediction in Individuals With Elevated Blood Pressure The USE-IMT Collaboration},
  url          = {http://dx.doi.org/10.1161/HYPERTENSIONAHA.113.02683},
  volume       = {63},
  year         = {2014},
}