Ateroesclerosis subclínica en población de riesgo cardiovascular bajo y moderado por Framingham chileno

• Paola Varleta ^[1] ; Roberto Concepción ^[2] ; Patricio Julio ^[1] ; Héctor Casanova ^[4] ; Carlos Navarrete ^[3]
  1. [1] Hospital Dipreca

     Hospital Dipreca

     Santiago, Chile

     
  2. [2] Hospital de Carabineros

     Hospital de Carabineros

     Santiago, Chile

     
  3. [3] Universidad de La Serena

     Universidad de La Serena

     La Serena, Chile

     
  4. [4] Carabineros de Chile Dirección de Previsión Medicina Preventiva

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• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 144, Nº. 1, 2016, págs. 30-38
• Idioma: español
• Títulos paralelos:
  • Subclinical atherosclerosis among Chilean subjects classified as having a low cardiovascular Framingham risk
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• Resumen

  • Background: Framingham risk score (FRS) has limitations and can underestimate risk. Carotid ultrasound to measure intima media thickness or plaques is recommended for cardiovascular risk assessment. Aim: To determine the prevalence of subclinical atherosclerosis in asymptomatic subjects classified as low and intermediate risk. Material and Methods: Cross-sectional study performed in subjects without cardiovascular disease. Cardiovascular risk was estimated using the Chilean FRS and the General Cardiovascular Disease FRS. Carotid ultrasound was performed in all subjects. We defined subclinical atherosclerosis as the presence of carotid plaque or intima media thickness greater than 75th percentile by gender and age. Results: We studied 203 subjects aged 47.2 ± 9.6 years (54% males). Mean intima media thickness was 0.62 ± 0.1 mm. An abnormal value was detected in 68 subjects (33%) and carotid plaques in 32 subjects (15.7%). Based on Chilean FRS, 96% were considered at low risk, 4% at intermediate, and none at high risk. In the low risk group the prevalence of abnormal intima media thickness and plaques was 40 and 14% respectively. Presence of plaques was more common in women than men (23 and 7% respectively, p < 0.01). According to the General Cardiovascular Disease FRS, 23% were at low, 39% at low intermediate and 28% at high intermediate risk. In the low risk group the prevalence of an abnormal intima media thickness was 34% and no subject had plaques. Conclusions: Carotid plaques were detected in Chilean subjects classified as having a low FRS risk. The underestimation of risk was higher in Chilean women.