Value of estimating pulse wave velocity compared to SCORE in cardiovascular risk stratification in community pharmacies

Med Clin (Barc). 2023 Dec 7;161(11):463-469. doi: 10.1016/j.medcli.2023.06.002. Epub 2023 Sep 19.
[Article in English, Spanish]

Abstract

Objectives: Arterial stiffness is considered to be an intermediate marker with independent prognostic value. The objective of this study is to assess whether the estimation of arterial stiffness can improve CV risk stratification compared to SCORE in patients at community pharmacies.

Methods: Observational prospective epidemiological study in which consecutive individuals entering a participating Community Pharmacy are offered a voluntary measurement of blood pressure and estimation of pulse wave velocity by oscillometry (AGEDIO, IEM®) to stratify their CV risk according to SCORE compared to the use of arterial stiffness.

Results: After nine months of recruitment, data from 923 patients (570 women, 353 men) were collected. 16/122 (13.1%) patients under 40 years and 72/364 (19.8%) over 65 years of age presented pathological stiffness and could be classified as high-risk, even though being out of the age-range of SCORE. Of the 437 (47.3%) patients who were susceptible to calculating SCORE, 42/437 patients (9.6%) presented pathological arterial stiffness. Cholesterol values were available in 281 patients (64.3%). Among them, according to SCORE, only 6 (2.1%) fell into the high-risk category.

Conclusions: More than half of the subjects who randomly enter a community pharmacy had ages that make it impossible to calculate the CV risk by SCORE. Among them, arterial damage was detected in 18.1%. Of the other half, 9.6% presented arterial damage and, therefore, high CV risk, when SCORE only detected it in 2.1%. Therefore, estimating arterial stiffness in community pharmacies markedly improves detection of high CV risk compared to SCORE.

Keywords: Arterial stiffness; Brachial oscillometry; Community pharmacies; Early vascular aging; Envejecimiento vascular prematuro; Farmacias comunitarias; Hipertensión; Hypertension; Oscilometría braquial; Pulse wave velocity; Rigidez arterial; Velocidad de la onda de pulso.

Publication types

  • Observational Study

MeSH terms

  • Blood Pressure
  • Cardiovascular Diseases* / diagnosis
  • Cardiovascular Diseases* / epidemiology
  • Female
  • Humans
  • Male
  • Pharmacies*
  • Prospective Studies
  • Pulse Wave Analysis
  • Risk Factors
  • Vascular Stiffness* / physiology