Risk factor Identification and Assessment in Hypertension and Diabetes (RIAHD) study

• Published in: Blood pressure 2006, Vol.15 (6), p.367-374
• Main Authors: Skrtic, S., Niklason, A., Leoo, T., Hedner, T.
• Format: Article
• Language: English
• Subjects: Absenteeism; Aged; Albuminuria; Albuminuria - epidemiology; Ambulatory; analysis; Anthropometry; blood; Blood Pressure Monitoring; Blood Pressure Monitoring, Ambulatory; Blood Proteins; Blood Proteins - analysis; Blood Viscosity; cardiovascular; Cardiovascular Diseases; Cardiovascular Diseases - epidemiology; Cohort Studies; Cost of Illness; diabetes; Diabetes Mellitus; Diabetes Mellitus - economics; Diabetes Mellitus - epidemiology; economics; epidemiology; Female; Health Services; Health Services - economics; Health Services - utilization; Humans; Hypertension; Hypertension - economics; Hypertension - epidemiology; Lipids; Lipids - blood; Male; MEDICAL AND HEALTH SCIENCES; MEDICIN OCH HÄLSOVETENSKAP; Metabolic Syndrome - economics; Metabolic Syndrome - epidemiology; Metabolic Syndrome X; microalbuminuria; Middle Aged; Risk Assessment; risk factor; Risk Factors; Sweden; Sweden - epidemiology; utilization; viscosity
• ISSN: 0803-7051; 1651-1999
• DOI: 10.1080/08037050601103984

The RIAHD (Risk factor Identification and Assessment in Hypertension and Diabetes) study was conducted as a non-interventional study in 699 patients with hypertension without additional risk factors (low-risk) or with additional risk factors (high-risk), primarily diabetes and or micro macroalbuminuria (MA A). The RIAHD study aimed to assess novel cardiovascular risk factors (RFs) such as blood viscosity, inflammatory markers and selected genetic polymorphisms. In addition, the RIAHD study also aimed to examine home versus office blood pressures (BPs), objective cardiovascular risk according to ESH ESC Systematic Coronary Risk Evaluation systems (SCORE) and subjectively expressed risk (clinical judgment) by physicians and patients. The health economic impact of other RFs, associated clinical conditions and target organ damage was also studied by evaluating healthcare utilization and sick leave in high-risk patients. In terms of circulating RFs, measured and calculated whole blood viscosity did not differ between the high and low-risk patient groups. Fibrinogen was significantly increased in the high-risk group, while hsCRP did not differ between the two groups. Self-measured BPs at home differed from BPs measured in the office. The average systolic home BPs was 11.8 mmHg lower in the low-risk group and 6.7 mmHg lower in the high-risk group. The diastolic home BPs averages differed 7.1mm Hg and 4.1mmHg from office BPs in the low-risk and high-risk groups, respectively. A higher home BP compared with the office BP, i.e. masked high BP values, was found in 21% of patients in the low-risk group and 32% of patients in the high-risk group. Global CV risk assessment (high-risk or low-risk) by the physicians corresponded well to objective risk evaluation (ESH ESC) in the high-risk hypertensive patients, while physicians tended to underestimate the patients CV risk in the low-risk group (without diabetes and or MA A). Proper global risk assessment by judgement is often difficult in cardiovascular patients. The RIAHD study emphasizes the importance of performing a more extended RF assessment in hypertensive patients with as well as without diabetes and or micro macroalbuminuria in order to expose the full RF profile.