Circulation, Vol 88, 1444-1455, Copyright © 1993 by American Heart Association
RB Devereux and MH Alderman
Conventional risk factors (especially high arterial pressure, elevated
cholesterol and glucose levels, and cigarette smoking) are useful
predictors of morbid atherosclerotic and hypertensive events, and their
control variably reduces the incidence of events. However, both the ability
to predict risk and the ability to reduce it by modification of established
risk factors are limited. These limitations occur in part because the
progression from risk factor exposure to morbid events depends on the
variable likelihood that individuals exposed to the same risk factors will
progress through two stages: the development of asymptomatic or
"preclinical" anatomic and functional cardiovascular disease in response to
standard risk factors and other variables, and the precipitation of morbid
events by progression of preclinical disease or by the action of additional
"triggering" mechanisms in the presence of preclinical disease. Advances in
diagnostic methodology now make possible accurate noninvasive detection in
many asymptomatic individuals of preclinical disease such as left
ventricular hypertrophy, carotid atherosclerosis, and renal dysfunction.
Progress in elucidating stimuli to left ventricular hypertrophy and
systemic atherosclerosis suggests that focusing research separately on
these two stages of disease evolution is a fruitful strategy. The closer
relation of measures of preclinical disease than risk factors with the
subsequent risk of complications indicates that their detection improves
clinical risk stratification. However, critical testing of whether clinical
outcome is improved or treatment cost is lowered by basing antihypertensive
or antihyperlipidemic treatment decisions in part on the presence of
preclinical cardiovascular disease is needed before this strategy is
adopted on a widespread scale.
ARTICLES
Role of preclinical cardiovascular disease in the evolution from risk factor exposure to development of morbid events
Department of Medicine, Cornell University Medical College, New York, NY.
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
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|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
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|
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|
|
|
|
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|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
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|
|
|
|
|
|
R. Weber, N. Stergiopulos, H. R. Brunner, and D. Hayoz Contributions of Vascular Tone and Structure to Elastic Properties of a Medium-Sized Artery Hypertension, March 1, 1996; 27(3): 816 - 822. [Abstract] [Full Text]
|
|
|
|
|
|
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|
|