Trends in the risk factors and signs of subclinical atherosclerosis in subjects at low and moderate risk according to the SCORE scale in different medical management tactics: Two-year follow-up results

Aim. To comparatively analyze the following parameters of the subclinical manifestations of atherosclerosis: carotid intima-media thickness (IMT), the presence and number of carotid atherosclerotic plaques (ASP), ankle brachial pulse wave velocity (ABPWV) in patients from 2 (active and conventional observation) groups at low and moderate risks according to the SCORE scale in two-year outpatient practice. Subjects and methods. A screening could select 600 able-bodied persons (445 women and 155 men) aged 30 to 65 years at low and moderate risks (according to the SCORE scale without atherosclerosis-associated diseases who were divided into 2 groups: A) active observation (n=400) and B) conventional medical management tactics (n=200). Five hundred and seven (85%) persons (339 in Group A and 168 in Group B) completed the study following 2 years. Carotid duplex scanning, computed sphygmography, and biochemical tests for blood lipid composition were performed. The delta index (%) calculated by the special formula, by subtracting the results during the first visit from those obtained 2 years later, was used to statistically analyze the time course of changes in the parameters under study. Results. Delta IMT (%) statistically significantly increased in Group B men as compared to that in Group A men (p=0.042). The delta parameter of total carotid stenosis, which reflected the percentage of the latter, proved to be high in both Group B women and men (p=0.0001) and the persons with a larger number of ASP were statistically significantly more in Group B (p=0.035). Delta ABPWV (%) was also greater in Group B (p=0.001). Conclusion. Just after 2 years, the active medical observation tactics in patients at low and moderate risks (according to the SCORE scale) can result in a reduction in the rate of subclinical atherosclerosis progression in the carotid artery.

subclinical atherosclerosis, cardiovascular risk, active medical tactics