Arteriograph & Primary Care
One of the most essential tasks of the general practitioner (GP) is to provide an accurate cardiovascular (CV) risk assessment of the patient. The usage of Arteriograph contributes to improve the CV risk stratification as the measurement not only provides the brachial blood pressure values, but also the arterial stiffness parameters as well, which are known to be independent predictors of the future cardiac events and sudden cardiac death.
Use Arteriograph to
1. Prediction of Cardiovascular Risk Using Framingham, ASSIGN and QRISK2: How Well Do They Predict Individual Rather than Population Risk?
There is little evidence about how precisely Framingham, ASSIGN and QRISK2 risk scores predict high CVD risk in individuals. The objective of this study was to evaluate the validity and reliability of these three evaluation methods in predicting individual CVD risk.
This study included 1.8 million people without CVD and prior to statin prescription, using the Clinical Practice Research Datalink. CVD, hospitalisation, and death due to CVD were recorded. Results showed that the Framingham, ASSIGN and QRISK2 risk scores do not predict the presence of high CVD risk well and consistently. Current practice to use any risk score in conjunction with a constant threshold level has created an arbitrary classification of high CVD risk.
In conclusion, existing CVD risk scores cannot be applied on high risk status population and may result in misclassification of subjects.
Deduced from this study, we can introduce Arteriograph as an innovative method in future cardiovascular risk assessment. Aortic Pulse Wave Velocity measured by this technique can calculate vascular age and predict cardiovascular morbidity independent of other traditional risk factors
2. The Prognostic Value of Arterial Stiffness in Systolic Heart Failure
This trial was designed to investigate the value of arterial stiffness in prognosis of patients with advanced heart failure (HF). The study followed up 98 patients diagnosed to have heart failure with a left ventricular ejection fraction less than 35%. Augmentation index (AIx) and pulse wave velocity (PWV) parameters were used as indicators of arterial stiffness measured by Arteriograph.
The main finding of this study is that arterial stiffness is a strong predictor of mortality in advanced HF, independently of other prognostic variables. Results suggest the measurement of arterial stiffness to be a convenient, inexpensive and reliable method for predicting mortality in patients with advanced HF. Additionally, this method can be used in outpatients with HF to optimise treatment and avoid hospitalisation.
3. Aortic Stiffness Measured By a Novel Oscillometric Method Independently Predicts Cardiovascular Morbidity and Mortality: A Study of 4146 Subjects
In this study, parameters with prognostic value like aortic pulse wave velocity (PWVao) were measured by Arteriograph, using a sole arm cuff showing that this method is much easier to apply with same accuracy compare to Carotid‐femoral pulse wave velocity (cfPWV) assessed by applanation tonometry.
Aortic stiffness in 4,146 subjects was evaluated. The detailed history of patients including pulse pressure (PP), ejection duration (ED), male gender, age, concomitant cardiovascular disease and treatment with thrombocyte inhibitors, body mass index (BMI), smoking, heart rate (HR), blood pressure (BP), augmentation index (AIx), diabetes, and cardiovascular drug therapy, were provided by Hungarian National Health Insurance Fund, which performed an independent statistical analysis.
Results showed that PWVao is independent of other major risk factors predicting mortality and other major cardiovascular events. This study is important because it has been done in a large cohort of subjects attending health screening. In conclusion, this study proved that using a simple oscillometric cuff method for assessing aortic stiffness may facilitate risk assessment in routine clinical practices.