P-374 MP-6: The impact of multiple laboratory testing on risk evaluation in people with high-normal and high blood pressure: Results from ICEBERG study

• Published in: American journal of hypertension 2005-05, Vol.18 (S4), p.141A-141A
• Main Authors: Buyukozturk, Kemalettin, Ilerigelen, Baris, Kabakci, Giray, Kozan, Omer, Koylan, Nevrez, Kanbolat, Mehmet, Toker, Sarper
• Format: Article
• Language: English
• Subjects: Risk Assessment; Risk Evaluation
• ISSN: 0895-7061; 1941-7225; 1879-1905
• DOI: 10.1016/j.amjhyper.2005.03.392

Background: Detection of left ventricular hypertrophy, atherosclerotic plaques of large arteries and renal injury in hypertension might provide more accurate risk classification, covering the underwater part of ICEBERG. Objectives: The primary purpose of Intensive / Initial Cardiovascular Examination regarding Blood pressure levels: Evaluation of Risk Groups (ICEBERG) study protocol is to determine the impact of different laboratory tests on cardiovascular risk stratification of subjects with BP levels ≥130/85 mm Hg. Methods: ICEBERG is a healthcare organization-based epidemiological study, conducted at 217 centers (20 cardiology -1- and 197 primary healthcare centers -2-). Each protocol had two arms: (A) treated hypertensive patients and (B) subjects with BP ≥130/85 mmHg; under no medication for at least 3 months. Risk assessment of 10.313 subjects was performed. Results: The study subjects were 57.6±11.6 years old. In 1A, when evaluated by clinical data, only 26.0% of subjects were in very high added risk group (VH). Further 10.5% switched to VH, when routine laboratory tests were applied. In 1B, 49.4% of the subjects were in VH with baseline evaluation. Further 9.5% switched from lesser to VH with intensive risk evaluation. When H and VH are combined, the proportion of subjects in H or VH bounced from 57.9% to 89.6%. In 2B, 38.2% of the subjects were in VH with baseline evaluation. Further 7.2% switched from lesser to VH with initial risk evaluation. Conclusion: When different risk evaluation panels are applied, up to 30% percent of the subjects switch from lesser to H or VH. Thus, evaluation of people with high-normal and high BP should include intensive methods to detect occult vascular target organ damage. (See Table) Protocol/arm N Panel 1-A 765 Serum biochemistry, Quantitative microalbuminuria, Serum hs-CRP, ECG 1-B 178 1-A plus Echo and Carotid USG 2-A 8503 Qualitative microalbuminuria 2-B 936 same as 1-A