Achieving target blood pressure and LDL Cholesterol does not prevent the progression of atherosclerotic plaque burden in a high-risk population
Date
2024-04-05Author
Pérez, Hernán Alejandro
Majul, Enrique A.
Oliszynski, Ana Laura
Agustin, Delia
Bocchetto, Delfina
Albrech, Candela
Báez, Iara Milena
Foa Torres, Ignacio
González Rinaldi, Luz María
Lambrechts, Sofía
Muñoz, Sonia
Carrillo, Mariana
Spence, J. David
García, Néstor H.
ORCID
https://orcid.org/0000-0002-6358-7940https://orcid.org/0000-0001-5417-2631
https://orcid.org/0009-0003-5939-6847
https://orcid.org/0000-0002-0396-4310
https://orcid.org/0000-0001-7478-1098
https://orcid.org/0000-0002-9057-9030
Metadata
Show full item recordAbstract
BACKGROUND AND AIMS: Atherosclerotic disease is a huge health burden worldwide, and its
prevention is largely focused on controlling traditional risk factors, despite limited effectiveness in
preventing cardiovascular disease (CVD) events. Improved risk stratification can be achieved by
identifying the progression of total plaque area (TPA) using carotid ultrasound, with the risk of CVD events
doubling when progression is detected over a 1-year interval. We hypothesize that blood pressure and serum
LDL cholesterol control at target values (current clinical guidelines) are insufficient to reduce the
progression of atherosclerosis in persons with high CVD risk
METHODS AND RESULTS: Prospective, observational study of 742 participants with high
cardiovascular risk in a cardiovascular primary prevention program. Two ultrasound measurements of TPA
were acquired for each participant for at least one year. We studied only those who maintained a blood
pressure below 130/80 mmHg and serum Low-Density Lipoprotein Cholesterol (LDL-C) below 100 mg/dl
throughout the study interval (57 participants). Participants with plaque progression of TPA > 5 mm2, were
compared to those with TPA changes of 5 mm2 or less (non-progression group) using a multivariable
logistic regression controlling for cardiovascular risk factors. We identified TPA progression in 22 of 57 (38.6%) participants. No differences were detected for any covariate when comparing progression versus non-progression. CONCLUSION: Progression of TPA occurs in as many as 38.6% of individuals despite maintaining BP below 130/80 and serum LDL-C below 100 mg/dl. TPA evaluation may help address the limitations of established guidelines for the prevention of CVD events in high-risk individuals.
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H A, P., E, M., A L, O., A, D., D, B., C B, A., I M, B., T I, F., L M, G. R., S A, L., S E, M., M N, C., J D, S., & N H, G. (2024). Alcanzar la presión arterial y el colesterol LDL objetivo no previene la progresión de la carga de placa aterosclerótica en una población de alto riesgo. Methodo Investigación Aplicada a Las Ciencias Biológicas, 9(2). https://doi.org/10.22529/me.2024.9(2)03
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